Spinal Anesthesia should always be given with a Adjuvant. Select the best suited Adjuvant . Based on Duration of Surgery Pain - intraop, postoperative Hypotension requirement etc etc Drugs commonly used as neuraxial analgesic adjuvants: Opioids: can be hydrophilic or lipophilic Hydroplhilic opioids - morphine, Pethidine, diamorphine, Buprenorphine , Butorphanol. Lipophilic opioids - fentanyl, alfentanil, sufentanil Adrenergics: Nonspecific alpha stimulation causes alpha1(a1) and alpha2 (a2) stimulation.
Nonspecific stimulants: epinephrine, norepinephrine, phenylephrine.Alpha2 (a2) stimulants: Clonidine , Dexmedetomidine GABA receptor agonists: Two receptor subtypes A and B exist. Benzodiazepines such as midazolam acts as a GABA A receptor agonist, whereas baclofen acts through the GABA B receptor. NMDA receptor antagonist: ketamine Calcium (Ca++) channel antagonist: ziconotide…
