الفهرس 
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Abstract
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.
This current study aimed to assess the effects of using nalbuphine (20 mg) as a bupivacaine 0.25% (10 ml) adjuvant in PECS I block compared to injecting bupivacaine 0.25% (10 ml) alone in fibroadenoma excision patients.
This trial enrolled 60 patients, 30 of whom received bupivacaine plus nalbuphine (group BN), and 30 in the bupivacaine only (group B). Postoperative VAS, SpO2 and vital signs at 0,1,2,4,6,12, 24 hours as well as the amount of morphine consumed, the time it took for the first analgesic to be administered and adverse effects were recorded and compared.
Regarding postoperative outcomes, a statistically significant difference between the two groups was not detected regarding VAS, SpO2, vital signs, and adverse effects. Similarly, there was no statistically significant difference in total morphine intake in the 24 hours following surgery between the two groups (p-value = 0.65). Only 9 out of 60 patients needed analgesia, 5 in the BN group and 4 in the B group, time to the first analgesic was not of statistically significant difference between BN & B groups, (211.8±71.29 & 183.5±29.872 minutes respectively) (p-value = 0.73). In terms of postoperative complications, there was no statistically significant difference between the two groups.