الفهرس 
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Abstract
Summarv Inguinal hernia repair is one of the most common elective operations performed worldwide for all age groups. It continues to be one of the most painful ambulatory surgeries, Postoperative pain is the most distressing symptom experienced by the patient. Pain is a subjective and complex multidimensional sensory experience that usually occurs as a result of tissue trauma. If postoperative pain is allowed to continue, it may result in significant dysfunction in organ systems which may progress to organ damage and even failure. The provision of intra and post operative analgesia is an integral part of the anesthetic practice. Caudal epidural analgesia has become one of the most popular and commonly performed regional blocks in pediatric anesthesia. It can be used with general anesthesia for intra- and postoperative analgesia in patients undergoing abdominal and lower-limb surgery. Bupivacaine is the most often used local anesthetic for caudal blocks in children. It provides analgesia which lasts for only 4-12 hours. Rescue analgesia is thus required when effect of block wears off. Prolongation of caudal analgesia has been achieved by the
addition of various additives. Different drugs like morphine, trarnadol. fentanyl, kctamine, clonidine, dexmedetomidine and midazolam were added to caudal space to prolong the postoperative analgesia. They were used in varying concentrations in different studies to achieve maximum benefit.