Objective: To compare the mean time of first analgesia with nalbuphine versus tramadol as adjuvant to bupivacaine for caudal block in children.

Patients and Methods: In this randomized clinical trial, a total number of 60 children who were planned for caudal block after infra-abdominal surgeries having age 3-12 years were included. A caudal block was performed under general anaesthesia immediately after surgery for postoperative analgesia. Tramadol 2mg/kg body weight was given caudally to individuals in group A. Group B patients had 0.125 percent bupivacaine with 0.1mg/kg nalbuphine caudally. Time of requirement of first analgesia was noted in all patients. Paracetamol 10 mg/kg was given as rescue analgesic in all patients.

Results: Mean age of patients was 8.30±3.03 years. Mean weight of patients was 23.33±6.92 Kg. There were 26 (43.33%) female patients and 34 (56.67%) male patients. There were 50 (83.33%) children who were having ASA status I, and remaining 10 (16.67%) children were having ASA status II. Mean pain score was 3.53±1.43 in tramadol group and 1.86±1.25 in Nalbuphine group (p-value <0.001. Mean time of first rescue analgesia was significantly prolonged in Nalbuphine group, mean time was 6.13±1.07 hours in Nalbuphine group versus 4.03±1.03 hours in tramadol group (p-value <0.001).

Conclusion: Single dose of nalbuphine as an adjunct to bupivacaine is superior as compared to tramadol in reducing the post-operative pain, it also significantly prolongs the duration of analgesia in children.

Keywords: Caudal Block, Nalbuphine, Tramadol, Post-operative pain, Time of first rescue analgesia.