This prospective, double-blinded, randomized clinical trial aims to examine the effects of combining isobaric bupivacaine with dexmedetomidine administered intrathecally (IT), compared to the combination of isobaric bupivacaine administered intrathecally and dexmedetomidine administered intravenously (IV), on spinal anesthesia prolongation time in minutes, time of regression from Bromage score 3 to 0.
Male and female patients in adult age group more than 18 years old
ASA classification I, II, and III.
Orthopedic surgery, including total hip replacement (THR) and total knee replacement (TKR).
No history of Obstructive sleep apnea
Patient below 18 years old of both genders.
ASA classification of IV and more.
Patients with a height of less than 150 cm.
Patients on alpha-two antagonist ACE inhibitors and CCB.