INTRODUCTION: Local anasthetic like bupivacaine is commonly used in spinal anaesthesia. Studies have shown that duration of analgesia due to bupivacaine in spinal anaesthesia can be prolonged by using adjuvants. Most commonly used opioid in regional anaesthesia is fentanyl. It is highly potent drug because of its high lipophilicity. The aim of the present study was to compare the effect of intrathecal fentanyl as adjuvant to low dose bupivacaine in the subarachnoid block with regular dose of bupivacaine. NEED FOR STUDY: The study was conducted to reduce the side effects of hyperbaric bupivacaine 0.5% given intracthecally in spinal anaesthesia by reducing the dose of it. AIM: The aim of the study was to evaluate the efcacy of intrathecal Hyperbaric bupivacaine 0.5% with 50mcg of fentanyl. OBJECTIVES: Level of block at the end of 10 minutes after giving spinal anaesthesia. Time taken by sensory block regression by two segments. Duration of analgesia. Intraoperative hemodynmic stability Adverse effects METHODS: Type and design of study: Randomised prospective study. Study population: The Study population included 60 patients undergoing below umbilical surgeries under spinal anaesthesia during November 2018 to December 2019. Study location: MVJ Medical college and research hospital. ETHICAL CLEARANCE: Obtained INCLUSION CRITERIA: Patients of ASA grade I,II and III Patients of both sexes posted for below umbilical surgeries Patients giving valid informed and written consent. EXCLISION CRITERIA: Patients refusal and contraindications for spinal anaesthesia. Patients below 35kgs and above 90kgs weight. Patients with history of hypersensitivity to drug used. METHODOLOGY: A randomized prospective clinical study involving 60 patients belonging to ASA physical status I to III and height from 150- 165cm. Routine pre-anaesthetic checkup was done. Valid informed written consent was obtained. Patients below 35 and above 90kgs were excluded. Patients were randomly divided into two groups of 30 each. Group A received 1.5ml of 0.5% hyperbaric bupivacaine with 50mcg fentanyl. Group B received 3ml of 0.5% hyperbaric bupivacaine, under aseptic precautions, Subarachnoid block was given in lateral position at L2-L3 using a 25 G Quincke's needle through midline approach and table in neutral position. Patients were turned supine immediately. The following parameters were noted: Onset of sensory block, Onset of motor block, Level of the sensory block, Duration of motor block, Duration of two segment sensory regression, Duration of analgesia, Parameters like HR, BP, SPO2 were recorded every 2 mins for the rst 10 minutes and every 10 minutes till the end of surgery, Any other adverse drug reactions like nausea, vomiting, urinary retention, pruritis etc were noted.There was no signicant difference in mean Onset of Sensory Block and motor block between two groups. RESULTS: There was no signicant difference in mean Onset of Sensory Block and motor block between two groups. There was signicant difference in mean Duration of sensory and motor block between two groups. A COMPARATIVE STUDY OF LOW DOSE HYPERBARIC BUPIVACINE WITH FENTANYL AND HYPERBARIC BUPIVACAINE IN SPINAL ANAESTHESIA FOR BELOW UMBILICAL SURGERIES. Original Research Paper Dr Tahir S Hatturkar Post Graduate MVJMC&RH Dr Jawabulla Vazhayil Post Graduate MVJMC&RH X 21GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Anaesthesiology KEYWORDS : VOLUME-9, ISSUE-2, FEBRUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dr Nirmala B C* Professor MVJMC&RH *Corresponding Author Dr Kaveti Vihitha Reddy Post Graduate MVJMC&RH 22 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS There was signicant difference in mean Duration of Analgesia between two groups(Group A=178.50 ± 17.96 min,Group B= 254.17 ± 24.53 min) DISCUSSION: Bupivacaine is the widely used anaesthetic agent for spinal anaesthesia. It has the advantage of producing good surgical anaesthesia and longer half-life compared to other local anaesthetics, the incidence of adverse effects on haemodynamic stability like hypotension ismorecommon. Perioperative hypotension will affect postoperative recovery and increases risk of coronary ischaemia. Intra thecal opioids are synergistic with local anaesthetics and intensify the sensory block. The addition of fentanyl to hyperbaric bupivacaine increases the intra-operative quality of block and synergistic antinociceptive effects with local anaesthetics will increase the duration of the block. The major advantages of neuraxial opioids are the preservation of preganglionic sympathetic function, postoperative analgesia and augmentation of spinal .This study had shown that addition of fentanyl to low dose of bupivacaine provided the same level of anaesthesia as that of higher dose of bupivacaine given alone with added advantage of haemodynamic stability. This combination can be especially useful for patients having ischaemic heart disease, diabetics with end organ damage, renal failure without coagulopathy and in patients with autonomic neuropathy. Results from our study shows that the baricity of the solution does not make any difference to the level of blockade or the density of blockade which is similar to 1the results of the study done by Roy G Soto et al. Thus we conclude that adding fentanyl helps in reducing the dose of bupivacaine for spinal anaesthesia in below umbilical surgeries without showing any signicant change in sensory and motor level block. It provides better intra and postoperative analgesia, good hemodynamic stability with no incidence of complications. CONCLUSION: Thus we conclude that adding fentanyl helps in reducing the dose of bupivacaine for spinal anaesthesia in below umbilical surgeries without showing any signicant change in sensory and motor level block. It provides better intra and postoperative analgesia, good hemodynamic stability with no incidence of complications. REFERENCES: 1. Soto RG, Paez JC, Smith RA. Impact of baricity of bupivacaine on intrathecal fentanyl-associated pruritus during combined spinal/epidural anesthesia for labor. The Internet Journal of Anaesthesiol 2009;20(1):1-6 2. Kotwani, M.B, Rupwate, K., Shivananda, P., & Magar, J. Comparison between high dose hyperbaric Bupivacaine (12.5 mg) alone versus low dose hyperbaric Bupivacaine (7.5 mg) with Fentanyl (25 µg) in spinal anaesthesia for inguinal hernia surgery. International journal of clinical trials,2016,08: 3(3), 140. 3. Shah S, Shah B, Deb C. A study of comparative evaluation of bupivacaine plain versus bupivacaine with fentanyl in spinal anaesthesia in geriatric patients. International Journal of Medical and Health Research. 2016;2:23-26. VOLUME-9, ISSUE-2, FEBRUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra