Analgesic Effect of Nalbuphine-Bupivacaine Combination in UltrasoundGuided Transversus Abdominis Plane Block in Patients Undergoing Major Abdominal Cancer Surgeries

Document Type : Original Article

Authors

1 Department of Anesthesia, Intensive Care and Pain Management, South Egypt Cancer Institute, Assiut University.

2 Department of Anesthesia, Intensive Care and Pain Management, Assiut University.

Abstract

Background:
TAP block is considered a modality of pain management following major
abdominal cancer surgeries. In this study, we are trying to determine whether
adding nalbuphine in two different doses as bupivacaine adjunct in bilateral
subcostal transversus abdominis plane block confers better post-major abdominal
cancer surgery pain management.
Methods:
A total of ninety patients undergoing major abdominal cancer surgeries were
haphazardly categorized into three groups. Group (B) obtained a TAP block with
bupivacaine only, group (N10) obtained a TAP block with bupivacaine and 10
mg nalbuphine, and group (N20) obtained a TAP block with bupivacaine and 20
mg nalbuphine. The main outcome of our study was the duration until the initial
request for analgesic intervention. The secondary outcomes were the quantity of
morphine administered within 24 hours after the surgery, postoperative VAS
scores, spirometric lung functions FEVI, FVC, and FEVI/FVC), and
postoperative side effects.
Results:
Significant differences were observed among the three groups (B, N10, and N20)
regarding the initial request for analgesia, total morphine consumption, VAS
score, and respiratory function. However, no meaningful distinctions were
observed between the groups regarding hemodynamics and side effects.
Conclusion:
Nalbuphine added to bupivacaine in TAP block has advantages over bupivacaine,
only more pain relief, less analgesic request, and less total amount of morphine in
patients undergoing cancer abdominal surgeries in a dose-dependent manner.

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