Introduction: Vaginal hysterectomy is the most common surgery done under spinal anaesthesia. The combination of local anaesthetics with adjuvants is getting more popular for better post-operative analgesia.

Aim: The purpose of our study is to evaluate and compare the addition of clonidine and neostigmine to intrathecal bupivacaine for prolongation of post-operative analgesia.

Materials & Methods: This was a prospective, randomized, controlled, double blind study carried out in patients undergoing vaginal hysterectomies. 50 patients of ASA grade I & II between 45-60years of age were assigned to 2 groups. Group BC: received 0.5ml of intrathecal clonidine (75g) along with 2.5ml of 0.5% Bupivacaine Group BN: received 0.5ml of intrathecal neostigmine(50g) along with 2.5ml of 0.5%bupivacaine.

Results: Sensory block onset, level of sensory block, duration of analgesia, motor block onset, duration of motor block, degree of motor block and recovery from motor block and incidence of side-effects are evaluated.

Conclusion: We concludefrom our study that intrathecal neostigmine 50g added to 12.5 mg hyperbaric bupivacaine significantly hastens the onset of sensory and motor block when compared to 75g clonidine and duration of analgesia is more prolonged with clonidine than neostigmine.