A comparative study of caudal epidural bupivacaine andbupivacaine plus nalbuphine in postoperative analgesiain children

BackgroundCaudal anesthesia (CA) is used in pediatrics to avoid the possible side effect of postoperative opioids and allows for smooth and rapid emergence from anesthesia. Opioids were added to the injection in CA to prolong the effect of anesthesia.ObjectiveTo compare the effect of bupivacaine alone and with nalbuphine in CA.Patients and methods A total of 40 patients scheduled for operations under general anesthesia combined with CA were divided into two groups: in group B, CA was carried out by injection of bupivacaine 0.25% in a dose of 1 ml/kg, and in group NB, CA was carried out by injection of bupivacaine 0.25% 1 ml/kg with nalbuphine 0.1 mg/kg. Hemodynamic changes, oxygen saturation, pain score at 2, 4, 6, 12, 24 h postoperative, sedation score, incidence of postoperative urine retention, and duration of motor block were compared in both groups. The respiratory depression effect of nalbuphine was also recorded. ResultsThere were no significant differences between the two groups regarding the hemodynamicchanges. There were significant differences in postoperative pain score and sedation as group NB had prolonged analgesia and prolonged sedation time than group B. There were no significant differences in urine retention and motor block between both groups. Conculsion Nalbuphine added to bupivacaine in CA provides longer postoperative analgesia and sedationwithout respiratory depression.