Effect of nalbuphine as an adjuvant on levobupivacaine induced caudal analgesia in children undergoing surgical procedures, controlled randomized double blinded

Background: To reduce intraoperative use of volatile anesthetics, a successful caudal blockade affords the anesthesiologist this opportunity. The use of a narcotic-sparing approach may benefit the patient, with providing a better postoperative course with less nausea. Aim of the work: To compare the effects of plain levobupivacaine 0.25% 1 ml/kg and levobupivacaine 0.25% 1 ml/kg plus nalbuphine 0.1 mg/kg single-shot caudal epidural for perioperative pain relief in children undergoing surgeries of lower half of the body. Patients and methods: The study was conducted in Abou El-Reesh pediatric hospital, Cairo University, after approval of ethical committee and obtaining consent from parents on 40 patient aged 1–9 years scheduled for surgeries of lower half of the body. (Group L, n = 20): Caudal block was done in this group using levobupivacaine 0.25% with the dose of 1 ml/kg after induction of general anesthesia. (Group L + N, n = 20): Caudal block was done in this group using levobupivacaine 0.25% with the dose of 1 ml/kg and nalbuphine 0.1 mg/kg after induction of general anesthesia. Results: The time to first analgesia was significantly longer in Group L + N (P