AbstractBackground Information: One of the challenges in postoperative care in a developing country is the non-availability of narcotics. Morphine and fentanyl have excellent analgesic action but they are difficult procure as they are under Narcotics act. Besides this, they have undesirable side effects like vomiting and respiratory depression. So alternatives for pain relief in the postoperative care are under constant search. Aim: Our aim was to primarily assess and compare the efficacy and safety of nalbuphine and tramadol as a preventive analgesic in patients undergoing elective inguinal hernia repair surgeries. Methods: This was a prospective, randomized, double-blind where sixty male patients undergoing elective inguinal hernia repair surgeries under spinal anaesthesia were randomly allocated to receive i.v nalbuphine (N) or tramadol (T) when the sensory level regressed to T10. Time to first rescue analgesic (duration of analgesia), rescue analgesic consumption in 24 hours, sedation, respiratory depression, postoperative nausea and vomiting were studied. Results: VAS values for group N at 4th and 6th hour were significantly lower than group T (p< 0.001)(p< 0.000). Mean VAS score remained less than 4 throughout the study in group N .Time to first rescue analgesia in group N (320.87±18.46) was statistically significant than group T (P=0.00) Requirement of total rescue analgesic in term of total number of doses in Group N (50) and Group T (72) (P=0.00). Conclusion: Our study concludes that pre-emptive administration of nalbuphine has a better analgesic profile than tramadol.