الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Spinal anesthesia is the most commonly used technique for infraumbilical surgeries (including genitourinary procedures) because of its unmatched reliability, effective analgesia and muscle relaxation (2). Spinal anesthesia also has a rapid onset of action, a relatively low side effect rate, shorter post-anesthesia care unit stay and is economical and easy to administer. Physiologically, spinal anesthesia is less invasive thus improving the outcome (3, 4).
However, these advantages of spinal anesthesia are associated with a relatively short duration of action and thus early analgesic intervention is needed in post-operative period (5). In order to improve the quality of blockage, prolong the duration of analgesia, and reduce the required dose of local anesthetics, appropriate adjuvants are commonly used. These adjuvants reduce the incidence of side effects caused by the use of high-dose local anesthetics, such as late and severe bradycardia, hypotension, nausea, and vomiting (6, 7). Bupivacaine is the most commonly used drug for spinal anesthesia. Opioids, α2 agonists, nalbuphine and ketamine are some examples of adjuvants used (8).