Comparison of Dexmedetomidine with Magnesium sulphate as an additional adjuvant to intrathecal Bupivacaine and Morphine combination for post operative analgesia in patients undergoing major abdominal Surgeries. A Prospective randomized double blind study.

Pain is an important hindrance to recovery from surgery and anaesthesia in the post-operative period.

Poorly managed postoperative pain after any surgery can impair surgical outcomes. it may become chronic pain . it can result in a prolonged duration of the hospital stay.

It can lead to more severe complications such as atelectasis, respiratory infection, myocardial infarction, and even bad surgical outcome or deathand thus it increases overall costs for society .

Adequate pain management is one of the most important factors in expediting recovery, by enabling fast mobilization.

Major abdominal incisions are commonly associated with persistent post-operative pain, in particular affecting respiratory function and also associated with increased analgesic requirement.

Effectively administered analgesia enables greater patient satisfaction by minimizing acute postoperative pain.

Through alleviating the acute physiological stress response to surgery it facilitates enhanced recovery outcomes including early mobilisation and return to normal activity, reduced length of hospital stay, and reduced cardiac, respiratory and gastrointestinal postoperative complications leading to improved long-term patient survival rates.

Opioids remain the main stay of treatment in these situations where there will be a continuous noxious stimulus from the incision site because of the ongoing respiratory excursions. Even though opioids are the most effective forms of medication that are being used in relieving pain ,they are associated with severe systemic side effectsand potential risk of addiction. Therefore, a general goal is to minimize exposure to the side effects of prolonged systemic narcotics while ensuring adequate analgesia.

This can be achieved with a multimodal approach combining regional anaesthesia, centrally-acting analgesics such as paracetamol, and drugs with a peripheral nonsteroidal anti-inflammatory effect  to minimize the opioid-related side effects while maintaining an effective level of pain control.

To evaluate and compare the total morphine consumption between two groups in the first 24 hrs and second 24 hrs following surgery.

The current study is designed to evaluate and compare the usefulness of Dexmedetomidine or magnesium sulphate as an additional adjuvant to a combination of intrathecal bupivacaine  and morphine for post operative analgesia in major abdominal surgeries.