Comparison between caudal levobupivacaine versus levobupivacaine–nalbuphine for postoperative analgesia in children undergoing hernia repair: A randomized controlled double blind study

AbstractObjectivesCaudal analgesia is widely used in children; the aim of this trial was to evaluate the efficacy of adding nalbuphine to local anesthetic in pediatric patients undergoing hernia repair.Patients and methodsThis randomized double-blind controlled trial was done in department of anesthesia, Cairo University hospitals, and 40 patients with ASA physical status classification I–II, aged 2–7years were enrolled in this study and randomly assigned into 2 groups; group L received caudal levobupivacaine 1ml/kg with concentration of 0.25% and group LN received caudal 0.125% levobupivacaine with volume of 1ml/kg plus 0.2mg/kg nalbuphine. Pain was evaluated immediately after emergence (FLACC 0h), after 1h in the PACU, after 2, 3, 4, 5, 6 and 12h by the FLACC pain score (Face, Leg, Activity, Crying, Consolability). First time of rescue analgesic, total dose of rescue analgesic and side effects were observed for 12h.ResultsFLACC pain scores were much less in LN group compared to L group (p value<0.001) after the second hour. The first time for postoperative analgesic requirement was significantly longer in LN group (384±23.1min) compared to L group (202.20±23.42min) (p value>0.001). The total dose of postoperative supplementary analgesia (intravenous paracetamol infusion) in the first 12h was significantly lower in LN group (200.5±65.5mg) in comparison with L group (355.25±69.9mg) (P