Analgesic effect of nulbuphine-bupivacaine combination in ultrasound guided Transversus abdominis plane block in patients undergoing major abdominal cancer surgeries.

Abstract

Background:TAP block is considered a modality of pain management following majorabdominal cancer surgeries. In this study, we are trying to determine whetheradding nalbuphine in two different doses as bupivacaine adjunct in bilateralsubcostal transversus abdominis plane block confers better post-major abdominalcancer surgery pain management.Methods:A total of ninety patients undergoing major abdominal cancer surgeries werehaphazardly categorized into three groups. Group (B) obtained a TAP block withbupivacaine only, group (N10) obtained a TAP block with bupivacaine and 10mg nalbuphine, and group (N20) obtained a TAP block with bupivacaine and 20mg nalbuphine. The main outcome of our study was the duration until the initialrequest for analgesic intervention. The secondary outcomes were the quantity ofmorphine administered within 24 hours after the surgery, postoperative VASscores, spirometric lung functions FEVI, FVC, and FEVI/FVC), andpostoperative side effects.Results:Significant differences were observed among the three groups (B, N10, and N20)regarding the initial request for analgesia, total morphine consumption, VASscore, and respiratory function. However, no meaningful distinctions wereobserved 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 inpatients undergoing cancer abdominal surgeries in a dose-dependent manner.