الفهرس 
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Abstract
In this study we evaluate the effects of up graded doses of neostigmine with intrathecal fentanyl, bupivacaine analgesia in 60 patients of either sex undergoing to lower limb orthopedic surgeries. The patients were allocated into 4 groups, 15 patients each, they received intrathecal bupivacaine 12.5mg, fentanyl 25flg and 0,12.5,25,50llg neostigmine respectively. After injection, the onset of motor and sensory blockade were recorded, and heart rate, blood pressure and oxygen saturation were recorded every 15 minutes intraoperative, also any complications were recorded. V AS were recorded until the patient complain of pain and total time of analgesia were recorded. In the present study there were an insignificant alterations in the heamodynamics, oxygen saturation and onset of motor and sensory block with increasing dose of neostigmine. However it was associated with increase in the duration of effective analgesia. The side effects specially nausea and vomiting was more frequent after neostigmine administration.