الفهرس 
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Abstract
Intrathecal anesthesia is a form of regional anaesthesia involving injection of a local anaesthetic into the Cerebrospinal Fluid (CSF), generally through a fine needle, usually 3.5 inches (9 cm) long. There are hyperbaric, isobaric and hypobaric solutions of anesthetics to be chosen for the spinal anesthesia. Usually, the hyperbaric is chosen, as its spread can be effectively and predictably controlled by the anaesthesiologist, by tilting the patient. Intrathecal anesthesia is very useful in patients having an irritable airway, anatomical abnormalities which make endotracheal intubation very difficult, borderline hypertensives where administration of general anaesthesia or endotracheal intubation can further elevate the blood pressure, and in some procedures in geriatric patients. It is the technique of choice for diabetic patients. There are many advantages for adjuvants of intrathecal anesthesia such as lowering dose of anesthetics in intrathecal anesthesia, prolonging duration of action of intrathecal anesthesia and giving more postoperative pain analgesia. There are many choices of adjuvants to produce intrathecal anesthesia: midazolam, ketamine, clonidine, neostigmine, magnesium sulfate, epinephrine and opioids (morphine, fentanyl and sufentanil). These adjuvants provide spinal anesthesia that range from 45 to 400 minutes and offer two clinical lengths of action: shorter (< 90 minutes) and longer (> 90 minutes).
Objectives: In this essay, we will study the effect of adding adjuvant drugs to local anesthetics in intrathecal anesthesia.