Spinal anesthesia has been named as the first major regional intervention introduced in our clinical practice. Spinal anesthesia, known as subarachnoid block is a safe technique. It is very reliable, cost effective and is easy to administer. Subarachnoid block works by providing surgical anesthesia with prolonged post-operative pain relief after surgery using various local anesthetic agents alone or in combination with adjuvants such as opioids, NMDA receptor antagonist. It blunts the autonomic and somatic responses. It has a quick onset associated with an effective blockage of sensory and motor system. It was first performed in by August Bier and from then on has been practiced widely. This study was done in Bareilly, UP where disparities in healthcare resources highlight the need to find the better adjuvant for effective sensory and motor block and quality of postoperative analgesia. Materials and Methods - A simple random sampling was done with 60 adult patients from the interval of May 2022 to 30th May 2024 at Rajshree medical college, Bareilly, UP. Participants were selected through random sampling to ensure demographic diversity. Data were collected through structured interviews, covering demographics, knowledge of adjuvants, sources of information and factors affecting spinal anesthesia levels. Statistical analysis was performed using SPSS version 23, null hypothesis significance testing and sample size program. Continuous variables such as age, income were expressed in terms of median, interquartile range, maximum and minimum. The outcome variables which were nominal expressed in terms of frequencies and percentages.Further Chi- square test or Fischer’s test was used.Results – The study revealed a balanced demographic distribution among participants, with equal representation of genders and a broad age interval. A comparative study with sixty patients of the age- range of 20 to 60 from ASA I & II participated in the study. Two groups, A and B, were randomly assigned to patients. The onset of sensory and motor blockage was equal in both groups. The duration of sensory and motor block were longer in clonidine plus ropivacaine group. The postoperative analgesia quality is also better in group having clonidine as adjuvant. Our research leads us to the conclusion that clonidine added to ropivacaine administered intrathecally improves sensory and motor blockage with improved hemodynamic stability, The slower regression of the block in the group receiving ropivacaine with clonidine, made it a better choice for longer duration lower limb surgery. When ropivacaine plus clonidine was used instead of ropivacaine plus fentanyl, the mean time for the initial rescue analgesia was longer, which decreased the need for analgesics in the early post-operative phase.

Introduction: hemodynamic changes during tracheal intubation it is more challenging in head injury patients . Dexmedetomidine is a selective α2 adrenoreceptor agonist used as a sedative and adjuvant with local anesthetic. We hypothesized that adding dexmedetomidine to lignocaine before intubation have positive outcome on hemodynamic changes. Aim and objective: To assess the effect of Intratracheal Dexmedetomidine with lignocaine on hemodynamic changes during intubation in head injury patient .Methodology: Sixty patients admitted in ICU with head injury and need intubation randomly divided into two groups 30 subjects in each group, namely, Group 1 and Group 2. Group 1 received dexmedetomidine 0.5 ml with 4% lignocaine 0.5 ml whereas Group 2 receive normal saline before endotracheal intubation, respectively. The outcomes were the incidence hemodynamic fluctuations during intubation and after intubation .Results: The incidence and severity of hemodynamic fluctuation in Group 1 than in the group 2, during intubation and post intubation is significantly lower . Moreover, compared with Group 2, Group 1 exhibited more stable haemodynamics during intubation as well as post intubation .Conclusion: The combined use of dexmedetomidine and lignocaine intratracheally before intubation significantly reduced the incidence and severity of haemodynamic fluctuations during and after intubation.