72 patients with lower limb orthopedic surgeries were randomized to receive epidural bupivacaine with either nalbuphine (n=24), dexmedetomidine (n=24), or saline as a control (n=24). The primary outcome of interest was the duration of postoperative analgesia. Secondary outcomes included the onset of epidural analgesia, sedation scores, patient satisfaction, adverse effects, pain on a Visual Analog Scale (VAS), mean arterial blood pressure (MAP), and heart rate (HR). Outcomes were assessed up to 24 hours postoperatively. Overall, the results of the study revealed that the addition of either nalbuphine or dexmedetomidine significantly prolonged the duration of postoperative analgesia compared to the control, with dexmedetomidine showing superior results. The findings suggest that dexmedetomidine is a more effective epidural adjuvant than nalbuphine for postoperative analgesia in lower limb orthopedic surgeries.