الفهرس 
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Abstract
The aim of this study was to evaluate the effect of adding low dose intathecal naloxone to bupivacaine - fentanyl spinal anesthesia in elderly patients scheduled for unilateral lower limb orthopedic surgeries. Postoperative complications, block characteristics, time to first analgesic requirement, total analgesic requirement, hemodynamic changes were also evaluated. Using low dose intrathecal naloxone as an adjuvant to bupivacaine-fentanyl spinal anaesthesia resulted in less incidence postoperative intrathecal fentanyl induced side effects, primarily pruritus, better post-operative pain scores and reduced analgesic requirements without causing significant adverse reactions in the studied sample. Addition of low dose naloxone provides a considerable improvement over the use of plain bupivacaine-fentanyl spinal anaesthesia. This randomized double-blind study was carried out in Mansoura University Hospitals, from November 2019 to December 2020. Ninety two patients of either sex with ASA (American Society of Anesthesiologists) physical status I, II or III aged ≥ 60 years undergoing unilateral lower limb orthopedic surgery under spinal anaesthesia were enrolled in this study after obtaining the approval from Institutional Review Board, Faculty of Medicine, Mansoura University.