Comparison of Analgesic Efficacy of Nalbuphine with Tramadol as Adjuvant to Local Anaesthetic in Caudal Block in Children

Objective: To compare the mean time of first rescue analgesia with Nalbuphine versus Tramadol as an adjuvant to Bupivacaine given for caudal block in children. Study Design: Quasi-experimental study Place and Duration of Study: Anesthesiology Department, Bolan Medical Complex Hospital, Quetta Pakistan, from Feb to Aug 2019. Methodology: The study included 60 patients, of either gender, aged 3-12 years. Group-A included patients who received 0.125% Bupivacaine 1ml/kg with Tramadol 2mg/kg body weight caudally. Group-B included patients who received 0.125% Bupivacaine with Nalbuphine 0.1mg/kg body weight caudally. The time required for the first rescue analgesia call was noted in all patients. Paracetamol 10 mg/kg intravenous was given as a rescue analgesic in all patients. Results: The mean age of patients was 8.30±3.03 years, and mean weight of patients was 23.33±6.92 Kg. There were 26(43.33%) female and 34(56.67%) male patients. The mean pain score was 3.53±1.43 in the Tramadol-Group and 1.86±1.25 in the Nalbuphine-Group (p-value<0.001). The mean time of first rescue analgesia showed significant prolongation in the Nalbuphine-Group compared to the Tramadol-Group. Conclusion: A single dose of Nalbuphine as an adjunct to Bupivacaine is superior to Tramadol in reducing post-operative pain when given caudally in paediatric patients. It also significantly prolongs the duration of analgesia in children.