Introduction: Surgeries like direct and indirect inguinal hernia repair, lower limb surgeries, urological surgeries and gynecological surgeries are commonly done under spinal anesthesia. It is a selective 2-
adrenoceptor agonist and is currently used for its sedative, analgesic and sympatholytic properties. Intravenous Dexmedetomidine decreases the inhalational anesthesia and opioid requirements during general
anesthesia. Aims: To compare the postoperative effect of intravenous dexmedetomidine in comparison with intravenous midazolam on intrathecal bupivacaine in patients undergoing gynecological surgeries under spinal anesthesia. Materials and Methods: Prospective randomized study between March 2017 and August 2018. This study was conducted in 100 patients belonging American Society of Anesthesiologists (ASA) physical status classification class 1 & 2 and undergoing gynecological surgeries under spinal anesthesia were included. Results: Postoperative analgesia was significantly prolonged with the use of intravenous dexmedetomidine premedication than with intravenous midazolam. Heart rates were lesser in dexmedetomidine Group A when compared to midazolam Group B, but overall requirement of anticholinergics was similar in both groups. Mean
arterial pressures were lower with dexmedetomidine Group A when compared with midazolam Group B. Conclusion: Intravenous dexmedetomidine premedication prolongs the duration of sensory and motor blockade during the spinal anesthesia with Bupivacaine with good sedation and postoperative analgesia than with intravenous midazolam premedication in patients undergoing gynecological surgeries under spinal anesthesia.