A comparative study between the efficacy of bupivacaine plus nalbuphine versus bupivacaine alone in pectoral nerve block for management of postoperative pain in patients undergoing breast fibroadenoma excision

Mohammed, Mostafa Salaheldeen; Abdel Latif, Samia Abdelmohsen; Nasr, Dalia Abdelhamid; Serry, Mostafa Mohamed

doi:10.1186/s42077-022-00240-3

A comparative study between the efficacy of bupivacaine plus nalbuphine versus bupivacaine alone in pectoral nerve block for management of postoperative pain in patients undergoing breast fibroadenoma excision

Authors

10.1186/s42077-022-00240-3

Abstract

Background
Breast surgeries, even the relatively minor ones, can be associated with significant postoperative pain affecting patients’ physical and psychological well-being. As a result, regional anaesthetic approaches have been used for breast surgery anaesthesia and analgesia. PECS I and II blocks have been proven to be relatively easy and safe in such regards. Moreover, using adjuvants, such as nalbuphine, have been proposed by many studies to intensify the block and decrease postoperative analgesic intake.
Results
Regarding postoperative outcomes, a statistically significant difference between the two groups was not detected regarding VAS, SpO, vital signs and adverse effects. Similarly, there was no statistically significant difference in total morphine intake in the 24 h following surgery between the two groups (-value = 0.65). Only 9 out of 60 patients needed analgesia, 5 in the BN group and 4 in the B group, and time to the first analgesic was not of statistically significant difference between BN and B groups (211.8 ± 71.29 and 183.5 ± 29.872 min respectively) (-value = 0.73). In terms of postoperative complications, there was no statistically significant difference between the two groups.
Conclusions
Adding nalbuphine (20 mg) to bupivacaine in PECS I block in fibroadenoma patients undergoing excision is not accompanied by a difference with statistical significance in postoperative VAS, morphine consumption and duration to the first analgesia when compared to bupivacaine alone.

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