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

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

igure 1 CONSORT flow participant diagram.

able 1 FLACC behavioral pain assessment scale [8].

	Score
Parameters	0	1	2
Face	No particular expression or smile	Occasional grimace or frown; withdrawn, disinterested	Frequent to constant frown, clenched jaw, quivering chin
Leg	Normal position or relaxed	Uneasy, restless, tense	Kicking or legs drawn up
Activity	Lying quietly, normal position, moves easily	Squirming, shifting back and forth, tense	Arched, rigid, or jerking
Crying	No cry (awake or asleep)	Moans or whimpers, occasional complaint	Crying steadily, screams or sobs; frequent complaints
Consolability	Content, relaxed	Reassured by occasional touching, hugging, or being talked to; distractible	Difficult to console or comfort

Score: 0, no pain; 1–3, mild pain; 4–7, moderate pain; 8–10, severe pain, FLACC: face, legs, activity, cry, and consolability.

able 2 Demographic data and duration of procedure.

	L Group (n = 20)	LN Group (n = 20)	P value
Age (years)	4.4 ± 1.51	4.32 ± 1.34	0.989
Weight (kg)	14.6 ± 2.8	14.5 ± 3.03	0.850
Sex (female/male)	13/7 (65%)	9/11 (45%)	0.204
ASA classification	1.2 ± 0.4	1.3 ± 0.47	0.471
Duration of procedure	56.2 ± 9.16	56.25 ± 10.11	0.871

Data are expressed as mean ± SD (standard deviation) or count and percentage.

able 3 Postoperative FLACC pain scores.

	L group (n = 20)	LN group (n = 20)	P value
FLACC 0 h	1.00 (0.00–1.00)	0.50 (0.00–1.00)	0.086
FLACC 1 h	1.00 (1.00–2.00)	1.00 (0.50–2.00)	0.013
FLACC 2 h	2.00 (1.00–2.00)	1.00 (1.00–1.50)	<0.001
FLACC 3 h	4.00 (3.00–4.00)	1.00 (1.00–2.00)	<0.001
FLACC 4 h	4.00 (4.00–4.00)	1.50 (1.00–2.00)	<0.001
FLACC 5 h	4.00 (4.00–5.00)	2.00 (2.00–3.00)	<0.001
FLACC 6 h	4.00 (4.00–5.00)	3.00 (3.00–3.00)	<0.001
FLACC 12 h	4.00 (4.00–4.50)	4.00 (3.00–4.00)	0.001

Data are expressed as median and interquartile range (IQR), FLACC: face, legs, activity, cry, and consolability.

able 4 Time to 1st rescue analgesic (min) and total dose of paracetamol (mg).

	L Group (n = 20)	LN Group (n = 20)	P value
Time to 1st rescue analgesic (min)	202 ± 23.42	384.9 ± 23	<0.001
Total dose of paracetamol in the 1st 12 h (mg)	355.25 ± 69.9	200.5 ± 75.65	<0.05

Data are expressed as mean ± SD (standard deviation).