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Background Peripheral nerve blocks provide prolonged analgesia restricted to the site of surgery e.g. penile block for circumcision or sciatic nerve block for pediatric surgery. The drawback is not all anesthesiologists are familiar with the necessary spectrum of peripheral nerve blocks in children. That is why Caudal block is preferred as all types of surgery below the umbilicus can be covered by it: ‘one technique fits all’. The main goal of caudal block is to provide postoperative pain relief, in addition it can be effective intraoperative and it is accepted that the block is performed in anesthetized children. Objectives The aim of this work is to compare Bupivacaine with Neostigmine and Bupivacaine alone as regard intraoperative hemodynamics and postoperative pain control for lower abdominal surgery in pediatrics. Patients and Methods Prospective randomized controlled clinical Trial. Conclusion In conclusion, caudal bupivacaine plus 2μg/kg neostigmine provided excellent analgesia lasting up to 24 hours post-operative, without serious side effects and minimal additional analgesics thus providing a safe, simple and effective postoperative analgesia for children undergoing lower abdominal surgery.

Comparison between Bupivacaine with Neostigmine and Bupivacaine alone in Caudal Block for Pediatrics undergoing Lower Abdominal Surgery