Pub Date : 2023-11-06DOI: 10.1080/11101849.2023.2277094
Magdy Mohammed Mahdy Sayed, Mohamed Galal Abdel-Rahim, Mahmoud Talaat Abd_elhafeez, Mostafa Samy Abbas
Background Intrathecal morphine (ITM) has been evidenced to provide efficient analgesia for hepatopancreaticobiliary surgery (HPB) in the postoperative period. Despite its benefits, ITM carries certain risks, such as pruritus, postoperative nausea and vomiting, and of utmost importance, the possibility of delayed respiratory depression. We conducted this study to compare the effectiveness of bilateral erector spinae plane block (ESPB) and ITM for analgesia following major HPB surgery. Our hypothesis was that bilateral ESPB would lead to a significant reduction in opioid consumption within the first 24 hours following surgery, with a lower incidence of side effects.
{"title":"Ultrasound guided erector spinae plane block versus intrathecal morphine for analgesia following major hepatopancreaticobiliary surgery","authors":"Magdy Mohammed Mahdy Sayed, Mohamed Galal Abdel-Rahim, Mahmoud Talaat Abd_elhafeez, Mostafa Samy Abbas","doi":"10.1080/11101849.2023.2277094","DOIUrl":"https://doi.org/10.1080/11101849.2023.2277094","url":null,"abstract":"Background Intrathecal morphine (ITM) has been evidenced to provide efficient analgesia for hepatopancreaticobiliary surgery (HPB) in the postoperative period. Despite its benefits, ITM carries certain risks, such as pruritus, postoperative nausea and vomiting, and of utmost importance, the possibility of delayed respiratory depression. We conducted this study to compare the effectiveness of bilateral erector spinae plane block (ESPB) and ITM for analgesia following major HPB surgery. Our hypothesis was that bilateral ESPB would lead to a significant reduction in opioid consumption within the first 24 hours following surgery, with a lower incidence of side effects.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-22DOI: 10.1080/11101849.2023.2263941
Alaa Ali M. Elzohry, Tarek Abdelazeem Sabra, Mohammed Moustafa Hussein, Fatma Al Zahraa Hamed Abdel Hameed, Mohamad Farouk. Mohamad
Background and objectives Excision of tumors from pelvis causing severe pain postoperatively. Hemodynamic stability, and better analgesia were documented when MgSO4 was used as an adjuvant to local anesthesia. We aimed to investigate the effect of using intrathecal MgSO4 with different doses as an adjuvant to LAs on postoperative acute pain, hemodynamics, and chronic pain.
{"title":"Safety and efficacy of different doses of intrathecal magnesium sulfate on the acute and chronic postoperative pain in patient undergoing pelvic cancer surgeries - a randomized controlled dose finding clinical study","authors":"Alaa Ali M. Elzohry, Tarek Abdelazeem Sabra, Mohammed Moustafa Hussein, Fatma Al Zahraa Hamed Abdel Hameed, Mohamad Farouk. Mohamad","doi":"10.1080/11101849.2023.2263941","DOIUrl":"https://doi.org/10.1080/11101849.2023.2263941","url":null,"abstract":"Background and objectives Excision of tumors from pelvis causing severe pain postoperatively. Hemodynamic stability, and better analgesia were documented when MgSO4 was used as an adjuvant to local anesthesia. We aimed to investigate the effect of using intrathecal MgSO4 with different doses as an adjuvant to LAs on postoperative acute pain, hemodynamics, and chronic pain.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135462949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-22DOI: 10.1080/11101849.2023.2271681
Mina Montasser, Wael Nabil Abdel Salam, Amany Elbanna, Dina Magdy, Ahmed A. Sabry
Background Upper gastrointestinal bleeding (UGIB) is a life-threatening emergency that causes considerable mortality and morbidity. The current study goal was to look at the endoscopic profile and clinical outcomes of patients with UGIB in Alexandria emergency department.
{"title":"Clinical outcome of early endoscopy in patients with acute upper gastrointestinal bleeding in Alexandria emergency department","authors":"Mina Montasser, Wael Nabil Abdel Salam, Amany Elbanna, Dina Magdy, Ahmed A. Sabry","doi":"10.1080/11101849.2023.2271681","DOIUrl":"https://doi.org/10.1080/11101849.2023.2271681","url":null,"abstract":"Background Upper gastrointestinal bleeding (UGIB) is a life-threatening emergency that causes considerable mortality and morbidity. The current study goal was to look at the endoscopic profile and clinical outcomes of patients with UGIB in Alexandria emergency department.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"27 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135462800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.1080/11101849.2023.2262187
Dina Hatem Ahmed, Mo’men Mostafa Youssef Makkey, Medhat Sayed Radwan, Ahmed Ismaiel Abdel Sabour
Background Russell–Silver syndrome (RSS) is an uncommon but well-known imprinting condition primarily characterized by postnatal development failure and idiopathic intrauterine growth retardation (IUGR) and an inverted triangular face and a prominent forehead with relative macrocephaly that distinguish it from idiopathic IUGR and other causes of postnatal growth failure. Few case reports of RSS with cleft palate have been published and those who have perioperative issue such difficult intubation owing to trismus and difficulty to use a mouthpiece due to mandibular development failure.
{"title":"A child with Russell–Silver syndrome (RSS) undergoing surgery for congenital cataract: Case report","authors":"Dina Hatem Ahmed, Mo’men Mostafa Youssef Makkey, Medhat Sayed Radwan, Ahmed Ismaiel Abdel Sabour","doi":"10.1080/11101849.2023.2262187","DOIUrl":"https://doi.org/10.1080/11101849.2023.2262187","url":null,"abstract":"Background Russell–Silver syndrome (RSS) is an uncommon but well-known imprinting condition primarily characterized by postnatal development failure and idiopathic intrauterine growth retardation (IUGR) and an inverted triangular face and a prominent forehead with relative macrocephaly that distinguish it from idiopathic IUGR and other causes of postnatal growth failure. Few case reports of RSS with cleft palate have been published and those who have perioperative issue such difficult intubation owing to trismus and difficulty to use a mouthpiece due to mandibular development failure.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Erector spinae plane block (ESPB) is a relatively new type of regional anesthesia that has demonstrated efficacy in pain management. The study uses ultrasound (US) guidance to perform the ESPB and evaluates its efficacy and safety compared to the traditional caudal block (CB) in managing postoperative pain in children undergoing lower limb surgeries.
{"title":"A comparative study of preoperative ultrasound-guided lumbar erector spine plane block and preoperative ultrasound-guided caudal block for postoperative pain control in pediatric lower limb surgeries: A randomized controlled trial","authors":"Amany Mohamed Abotaleb, Elsayed Elhamy Negm, Wafaa Madhy Abdelwahed","doi":"10.1080/11101849.2023.2260590","DOIUrl":"https://doi.org/10.1080/11101849.2023.2260590","url":null,"abstract":"Background Erector spinae plane block (ESPB) is a relatively new type of regional anesthesia that has demonstrated efficacy in pain management. The study uses ultrasound (US) guidance to perform the ESPB and evaluates its efficacy and safety compared to the traditional caudal block (CB) in managing postoperative pain in children undergoing lower limb surgeries.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"216 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136280189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.1080/11101849.2023.2261699
Donia Hany Saad, Ahmed Mansour Ahmed Abdou, Moustafa Abdelaziz Moustafa, Saad Eldesouky Elzayat, Aly Mahmoud Moustafa Ahmed
Background Ultrasound (US)-guided pterygopalatine fossa (PPF) block helps to improve the field of surgery and control hemodynamic fluctuations during functional endoscopic sinus surgery (FESS).
{"title":"Perioperative outcome of ultrasound-guided pterygopalatine fossa block in functional endoscopic sinus surgery: A randomized controlled trial","authors":"Donia Hany Saad, Ahmed Mansour Ahmed Abdou, Moustafa Abdelaziz Moustafa, Saad Eldesouky Elzayat, Aly Mahmoud Moustafa Ahmed","doi":"10.1080/11101849.2023.2261699","DOIUrl":"https://doi.org/10.1080/11101849.2023.2261699","url":null,"abstract":"Background Ultrasound (US)-guided pterygopalatine fossa (PPF) block helps to improve the field of surgery and control hemodynamic fluctuations during functional endoscopic sinus surgery (FESS).","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136280192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.1080/11101849.2023.2258655
Alaaeldin A. Aiad, Ahmed A Metwally, Nesma M. Abo-Elinein, Zeinab A. Kasemy, Essam A Ismael
Background Rectus sheath block (RSB) is an effective nerve block. This study aimed to compare adenosine and magnesium sulfate as an adjuvant for ultrasound-guided RSB (UG-RSB).
{"title":"Comparison between adenosine and magnesium sulfate as an adjuvant for ultrasound-guided rectus sheath block. A prospective randomized controlled study","authors":"Alaaeldin A. Aiad, Ahmed A Metwally, Nesma M. Abo-Elinein, Zeinab A. Kasemy, Essam A Ismael","doi":"10.1080/11101849.2023.2258655","DOIUrl":"https://doi.org/10.1080/11101849.2023.2258655","url":null,"abstract":"Background Rectus sheath block (RSB) is an effective nerve block. This study aimed to compare adenosine and magnesium sulfate as an adjuvant for ultrasound-guided RSB (UG-RSB).","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136280184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-28DOI: 10.1080/11101849.2023.2261700
Minatallah A. Elshafie, Mohamed S. Alwarraky, Nagwa I. Mowafy, Maha L. Elsheikh, Amin M. Alansary
Background Anesthesia for transjugular intrahepatic portosystemic shunt (TIPS) for lowering raised portal pressure is clinically challenging. As patients, candidates for TIPS are medically complex due to chronic liver disease, adding to remote area anesthesia’s complexities. Multimodal analgesia, including erector spinae plane block (ESPB), can improve anesthesia quality with patient satisfaction.
{"title":"Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial","authors":"Minatallah A. Elshafie, Mohamed S. Alwarraky, Nagwa I. Mowafy, Maha L. Elsheikh, Amin M. Alansary","doi":"10.1080/11101849.2023.2261700","DOIUrl":"https://doi.org/10.1080/11101849.2023.2261700","url":null,"abstract":"Background Anesthesia for transjugular intrahepatic portosystemic shunt (TIPS) for lowering raised portal pressure is clinically challenging. As patients, candidates for TIPS are medically complex due to chronic liver disease, adding to remote area anesthesia’s complexities. Multimodal analgesia, including erector spinae plane block (ESPB), can improve anesthesia quality with patient satisfaction.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135425678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-11DOI: 10.1080/11101849.2023.2256564
Abdelmoneim Adel Abdelmoneim, Sarah Abdelrasoul Hafez, Maha Gmail Hanna, Dalia Saad Abdel Kader
ABSTRACT Background The standard dose of bupivacaine used in axillary brachial plexus block (ABPB) in pediatrics is 0.5 ml/kg of bupivacaine 0.25%. However, bupivacaine (0.19%) is still to be investigated for peripheral nerve block in pediatrics regarding the efficacy and adequacy of intra- and postoperative analgesia and degree of motor affection. We aimed to compare different concentrations (0.25%, 0.19%) of bupivacaine plus dexmedetomidine mixture to perform US-ABPB in pediatrics undergoing upper limb surgery distal to the elbow regarding affecting the postoperative motor power and adequacy of intra- and postoperative analgesia. Methods This prospective, randomised-controlled, double-blinded work was performed on 60 pediatric individuals presenting for upper limb orthopedic surgeries in the wrist, hand, and elbow distal to cubital fossa with surgical time planned to not exceed 1 h. 0.25% bupivacaine plus 1 µg/kg dexmedetomidine (Group A) or 0.19% bupivacaine in addition to 1 µg/kg dexmedetomidine (Group B) were given at random to participants. Motor power and pain were assessed using the Modified Bromage scale, Face, Legs, Activity, Cry, and Consolability (FLACC) score, respectively. Results A highly substantial variation was recorded between the two groups in Bromage 0 till Bromage 60 with higher values in group (B), and no substantial variation was found in Bromage 90 till Bromage 180 existed between the two groups. No substantial variation existed among the two groups with regard to FLACC score in FLACC0 (immediately after recovery), 1st hour after recovery, and 12th hour after recovery, and FLACC was significantly more (p < 0.05) in group B contrasted to group A in the 4th hour after recovery and 8th hour after recovery. Conclusion Using a lower concentration of bupivacaine (0.19%) plus dexmedetomidine (1 µg/kg) was associated with regain of postoperative motor power with the same postoperative analgesic efficacy compared to the standard concentration (0.25%) bupivacaine plus dexmedetomidine (1 µg/kg) in the early postoperative period in US-ABPB.
{"title":"The motor effects of 0.25% bupivacaine vs 0.19 bupivacaine in ultrasound-guided axillary brachial plexus block in pediatrics undergoing below-elbow orthopedic surgeries: A randomized controlled study","authors":"Abdelmoneim Adel Abdelmoneim, Sarah Abdelrasoul Hafez, Maha Gmail Hanna, Dalia Saad Abdel Kader","doi":"10.1080/11101849.2023.2256564","DOIUrl":"https://doi.org/10.1080/11101849.2023.2256564","url":null,"abstract":"ABSTRACT Background The standard dose of bupivacaine used in axillary brachial plexus block (ABPB) in pediatrics is 0.5 ml/kg of bupivacaine 0.25%. However, bupivacaine (0.19%) is still to be investigated for peripheral nerve block in pediatrics regarding the efficacy and adequacy of intra- and postoperative analgesia and degree of motor affection. We aimed to compare different concentrations (0.25%, 0.19%) of bupivacaine plus dexmedetomidine mixture to perform US-ABPB in pediatrics undergoing upper limb surgery distal to the elbow regarding affecting the postoperative motor power and adequacy of intra- and postoperative analgesia. Methods This prospective, randomised-controlled, double-blinded work was performed on 60 pediatric individuals presenting for upper limb orthopedic surgeries in the wrist, hand, and elbow distal to cubital fossa with surgical time planned to not exceed 1 h. 0.25% bupivacaine plus 1 µg/kg dexmedetomidine (Group A) or 0.19% bupivacaine in addition to 1 µg/kg dexmedetomidine (Group B) were given at random to participants. Motor power and pain were assessed using the Modified Bromage scale, Face, Legs, Activity, Cry, and Consolability (FLACC) score, respectively. Results A highly substantial variation was recorded between the two groups in Bromage 0 till Bromage 60 with higher values in group (B), and no substantial variation was found in Bromage 90 till Bromage 180 existed between the two groups. No substantial variation existed among the two groups with regard to FLACC score in FLACC0 (immediately after recovery), 1st hour after recovery, and 12th hour after recovery, and FLACC was significantly more (p < 0.05) in group B contrasted to group A in the 4th hour after recovery and 8th hour after recovery. Conclusion Using a lower concentration of bupivacaine (0.19%) plus dexmedetomidine (1 µg/kg) was associated with regain of postoperative motor power with the same postoperative analgesic efficacy compared to the standard concentration (0.25%) bupivacaine plus dexmedetomidine (1 µg/kg) in the early postoperative period in US-ABPB.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136024251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-11DOI: 10.1080/11101849.2023.2253639
Ahmed Omar Mahmoud Abdallah, Mohamed H Bakri, Hany El-Morabaa, Tasbeeh K Zanaty, Hanan Galal, Marwa Mahmoud Abdel Rady
ABSTRACT Background We hypothesized that adding nalbuphine to bupivacaine would prolong the duration of caudal epidural anaesthesia (CEA) in pediatric patients undergoing hypospadias repair surgery. Methods 60 children scheduled for elective hypospadias surgery under general anesthesia combined with CEA were divided into two equal groups: the control group received caudal bupivacaine 0.25% 1 ml/kg plus 2 ml normal saline. The Nalbuphine group received caudal bupivacaine 0.25% 1 ml/kg plus nalbuphine 0.1 mg/kg in 2 ml normal saline. Intraoperative and postoperative rescue analgesia was managed by giving intravenous paracetamol 15 mg/kg and/or 100mcg nalbuphine. The Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, and the Richmond AgitationSedation Scale (RASS) score were measured. Pre-operative and postoperative blood samples were collected for a subgroup of patients for cortisol analysis. Results The duration of postoperative analgesia was significantly longer in the nalbuphine group (p < 0.001). The number of patients who needed postoperative supplemental analgesia was significantly lower in the nalbuphine group (p < 0.001). Total paracetamol consumption was significantly higher in the control group (p < 0.001). The FLACC and RASS were significantly lower in the nalbuphine group. Postoperative cortisol levels were lower in the nalbuphine group compared to the control group. Conclusions Adding caudal nalbuphine 0.1 mg/kg to bupivacaine 0.25% provides better postoperative pain control than bupivacaine alone in children undergoing hypospadias repair.
{"title":"Efficacy of adding nalbuphine to caudal bupivacaine for postoperative analgesia in children undergoing hypospadias repair surgery. Randomized controlled trial","authors":"Ahmed Omar Mahmoud Abdallah, Mohamed H Bakri, Hany El-Morabaa, Tasbeeh K Zanaty, Hanan Galal, Marwa Mahmoud Abdel Rady","doi":"10.1080/11101849.2023.2253639","DOIUrl":"https://doi.org/10.1080/11101849.2023.2253639","url":null,"abstract":"ABSTRACT Background We hypothesized that adding nalbuphine to bupivacaine would prolong the duration of caudal epidural anaesthesia (CEA) in pediatric patients undergoing hypospadias repair surgery. Methods 60 children scheduled for elective hypospadias surgery under general anesthesia combined with CEA were divided into two equal groups: the control group received caudal bupivacaine 0.25% 1 ml/kg plus 2 ml normal saline. The Nalbuphine group received caudal bupivacaine 0.25% 1 ml/kg plus nalbuphine 0.1 mg/kg in 2 ml normal saline. Intraoperative and postoperative rescue analgesia was managed by giving intravenous paracetamol 15 mg/kg and/or 100mcg nalbuphine. The Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, and the Richmond AgitationSedation Scale (RASS) score were measured. Pre-operative and postoperative blood samples were collected for a subgroup of patients for cortisol analysis. Results The duration of postoperative analgesia was significantly longer in the nalbuphine group (p < 0.001). The number of patients who needed postoperative supplemental analgesia was significantly lower in the nalbuphine group (p < 0.001). Total paracetamol consumption was significantly higher in the control group (p < 0.001). The FLACC and RASS were significantly lower in the nalbuphine group. Postoperative cortisol levels were lower in the nalbuphine group compared to the control group. Conclusions Adding caudal nalbuphine 0.1 mg/kg to bupivacaine 0.25% provides better postoperative pain control than bupivacaine alone in children undergoing hypospadias repair.","PeriodicalId":11437,"journal":{"name":"Egyptian Journal of Anaesthesia","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136024404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}