Background and Aim: Various studies have been done on addition of various adjuncts to spinal local anaesthetics to improve as well as to increase the time of spinal anesthesia and analgesia, so that the total dose of local anaesthetics could be decreased. Present study was done with an aim to evaluate the relative efficacy of dexmedetomidine and
fentanyl with 0.5% hyperbaric bupivacaine intrathecally in Endo-urological procedures.

Material and Methods: Total 80 patients of ASA grade I and II, between 18 to 70 years were scheduled for different Endo-urological surgeries including Turp, Turbt, End To End Urethroplasy,Suprapubic Cystolithotrity/Suprapubic Cystolithotomy And Urs (Lower ureteric stone) and RIRS were included in the study. Patients were allocated into 2 groups, each of 40 patients, each received a total volume of 3.5ml which contained dose of 15mg (i.e. 3ml) 0.5% hyperbaric bupivacaine
combined either Dexmedetomidinne or Fentanyl. After noting baseline parameters the patients were monitored using continuous electrocardiography (lead II), heart rate, non-invasive blood pressure, and continuous pulse oximetry.

Results: The changes in mean heart rate between two groups were significant statistically after 60 minutes of spinal anaesthesia, which showed more fall in heart rate in patients of group-D than group-F. The changes in mean arterial pressure were also statistically significant between the two groups after 75 minutes of spinal anaesthesia, which showed more fall in patients of group-D. Intra–operative hypotension requiring treatment was also observed more in group-D patients (12.5%) compared to group-F (2.5%).

Conclusion: Dexmedetomidine is a good option to fentanyl in spinal anesthesia as it significantly prolongs duration of sensory and motor block and increase the duration of analgesia, it causes hypotension and bradycardia which are easily reversible and without any untoward adverse events.