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Adjuvants premixed with local anaesthetic solution can alter the density of the hyperbaricsolution affecting the spread of block. Administering local anaesthetic and adjuvant in a separate syringemay minimize these changes with respect to densities. Hence we aimed to compare the efficacy of the drugswhen administered sequentially and as a mixture.Objective: To compare the efficacy of neuraxial blockade with pre- mixed fentanyl and 0.5% hyperbaricbupivacaine and sequential administration of fentanyl and 0.5% hyperbaric bupivacaine.Materials and Methods: After obtaining the institutional ethics committee approval, patients wererandomly allocated into Group M = received spinal anesthesia using 15mg of 0.5% bupivacaine heavy and25mcg fentanyl premixed in the same syringe. Group S = received spinal anesthesia sequentially. Drugswere injected through 25 gauge quincke’s needle in sitting position, inserted at L3-L4 space. Onset of block,hemodynamics, duration of analgesia and complications were monitored.Results: Group S had slower onset and slow progression of the block with more time taken to regressionof the block compared to the group Incidence of hypotension ,bradycardia was less in group S compared togroup M.Conclusion: We conclude that administrating adjuvants to local anaesthesia sequentially is better thanmixing them in a single syringe in terms of surgical anaesthesia, hemodynamic stability and post operativepain relief.Keywords: Adjuvants premixed, Bupivacaine, Fentanyl, Sequential administration.

indian journal of clinical anaesthesia

Randomized controlled study comparing the efficacy of neuraxial blockade by using intrathecal administration of 0.5% hyperbaric bupivacaine 15mg and fentanyl 25mcg - in a single syringe versus separate syringe techniques in inguinal hernia surgeries