الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Dexmedetomidine is a highly selective α-2 adrenergic receptor agonist which when used in recommended dose in the form of an infusion has several desirable properties like sedation, anxiolysis, sympatholysis, analgesia, stimulation of uterine contractions, decreased intraoperative anaesthetic requirements (Narcotic, inhalational), cardiovascular stability, smooth recovery when used as an adjunct to general anaesthesia and above all preserves respiratory function. It was approved by United States Food and Drug Administration (US FDA) in 1999 for use in humans for short-term sedation and analgesia in Intensive Care Unit (ICU) for less than 24 hours. (Kaur,& Singh,2011) (Grewal, 2011) Pain during childbirth has been described by women as severe and frequent. Satisfactory analgesia is of paramount importance in labour.Pain relief not only provides patient’s comfort, but also attenuates the release of stress hormones, whose actions can draw from the parturients reserves as well as deprive the foetus of oxygen and nutrients.(Halpernet al,2004).Parenteral opioids and sedatives are the most frequently prescribed agents for women in labour in many poor resource settings( Mordani&Macarthur, 2004). Spinal anesthesia is most commonly used technique for cesarean section as it is very economical, easy to administer and has rapid onset of action. Hyperbaric bupivacaine is commonly used as local anesthetic for spinal anesthesia in cesarean section. Intrathecal local anesthesia alone is associated with relatively short duration of action and thus early analgesic intervention is needed in post-operative period. Various drugs are used along with local anesthetics to facilitate the prolongation of duration of spinal block both for long procedures and for postoperative pain relief. Opioids are the commonly used adjuvant in clinical practice as pethidine, Fentanyl which is a lipophilic opioid, can produce more rapid onset and better quality surgical block. However the addition of opioids to local anesthetic solution has disadvantages such as puriuritis and respiratory depression(James,.et al. 2005).Dexmedetomidine is a highly selective α-2 agonist, when used as a neuraxial adjuvant has shown to provide stable hemodynamic conditions, good quality of intraoperative and prolonged postoperative analgesia with minimal side effects. (Al-Mustafa,. et al. 2009).