Background: Hip and knee surgery is frequently performed under intrathecal bupivacaine with a morphine solution. An intrathecal addition of adrenaline has been shown to enhance and prolong the duration of postoperative analgesia without any added risks.  Objective: To evaluate the effects of adrenaline to intrathecal isobaric bupivacaine with morphine in elderly patients undergoing hip or knee surgery ; to compare the time of first morphine request, total morphine requirements in the first 48 h and side effects.  Method: In this prospective double-blind study, 40 patients, age ≥ 60 yr., ASA I-III, and undergoing hip or knee surgery were randomly assigned to two groups of 20 patients. Each patient in the M group received a morphine dose of 0.1 mg and patients in the MA group received a morphine dose of 0.1 mg with 0.2 mg of adrenaline in addition to intrathecal isobaric bupivacaine. The time of first morphine request, total morphine requirements in the first 48 h and side effects were evaluated. Postoperative pain was assessed by using a verbal numerical pain score (VNS).  Results: The demographic data of both groups were com- parable. There was no significant difference in time of first morphine request between the M group [505 (375-1025) min] and the MA group [520 (385-1165) min] (p = 0.98). The total morphine requirements in the first 48 h were also comparable between the M group [3 (0-15) mg] and the MA group [3 (0-12) mg] (p = 0.06). However, patients who had not required morphine during the postoperative period were 5.9% and 37.5% in the M and MA groups, respectively (p =0.02). Patients who required morphine ≥ 12 mg during the postoperative period were 41.1% and 6.2% in the M and MA groups, respectively (p = 0.03). Although there was no significant difference in the sedation score, pruritus and nausea/vomiting within 48 hours postoperatively. No patient exhibited respiratory depression, postdural puncture headache (PDPH) or tran-sient neurological symptoms (TNS).  Conclusion: These results suggest that the addition of 0.2 mg of adrenaline to 0.5% intrathecal isobaric bupivacaine with 0.1 mg of morphine does not prolong the duration of analgesia and does not reduce total morphine requirements in the first 48 hours postoperatively for hip or knee surgery in elderly patients.