Efficacy of Nalbuphine as An Adjunct to 0.5% Bupivacaine in Ultrasound- Guided Suprazygomatic Maxillary Nerve Block in Patients Undergoing Nasal and Maxillofacial Surgery – A Randomized Clinical Comparative Study

Background & Aims: Ultrasound-guided suprazygomatic maxillary nerve block (MNB) is safe and efficacious in nasal and maxillofacial surgeries. The analgesic effect of nalbuphine is equal to that of morphine, with a ceiling effect on respiration. Therefore, this study aims to evaluate the efficacy of 0.2 mg/kg nalbuphine as an adjuvant to 0.5% bupivacaine compared to plain 0.5% bupivacaine in maxillary nerve block.
Material & Methods: One hundred ASA I-II patients of either sex, scheduled for elective nasal and maxillofacial surgeries under general anesthesia, were randomly allocated into Group A and B (n=50) to receive USG-guided suprazygomatic MNB. Group A and Group B received 0.5% bupivacaine with 0.2 mg/kg of nalbuphine and 0.5% bupivacaine, respectively. The mean duration of analgesia, total consumption of opioids, and 24-hour postoperative side effects were recorded in both groups. The data were compared using Student's t-test, Chi-square test, and Mann–Whitney U test. P < 0.05 was considered statistically significant.
Results: The mean duration of postoperative analgesia was significantly prolonged in the nalbuphine group (769.2 ± 117 vs. 559.2 ± 75 minutes; p = 0.002), with a significant reduction in the total consumption of nalbuphine (26.4 ± 5.06 vs. 52.77 ± 7.46 mg; p = 0.007) compared to the bupivacaine group.  
Conclusion: 0.2 mg/kg nalbuphine can be effective as an adjuvant to local anesthetics in MNB to prolong the postoperative duration of analgesia without significant side effects.