nalbuphine and Breast-Neoplasms

This study aimed to compare the effect of dexamethasone added to fentanyl and bupivacaine with the effect of either dexamethasone or fentanyl alone when combined with bupivacaine in the thoracic paravertebral block (TPVB).. Sixty female patients (aged 18-60 years), scheduled for modified radical mastectomy were enrolled. Patients received preoperative unilateral paravertebral block using 0.3 mL/kg of 0.5% bupivacaine combined with 8 mg dexamethasone (group 1), 1 μg/kg fentanyl (group 2), or 8 mg dexamethasone + 1 μg/kg fentanyl (group 3). The study drugs were diluted with normal saline 0.9% up to 25 mL volume. The primary outcome was the time to first postoperative analgesics request, Secondary outcomes were total analgesic consumption, verbal rating pain scale (VRS) over the first 24 hours postoperatively, hemodynamic parameters, and adverse effects.. The time to first analgesic request for intravenous (IV) nalbuphine was longer in group 2 (15.75±0.9 h, P<0.001) than group 1 (10.45±1.1 h, P<0.001), while no patients requested it in group 3 (P<0.001). The total analgesic consumption of IV nalbuphine was lower in group 2 (8.6±3.5mg, P=0.04) than group 1 (11.3±2.1 mg), with a significant difference between group 2 and 3 (P<0.001). From the 8. Dexamethasone and fentanyl combination enhances the analgesic effect of bupivacaine in TPVB.

Topics: Analgesics; Anesthetics, Local; Breast Neoplasms; Bupivacaine; Dexamethasone; Double-Blind Method; Female; Fentanyl; Humans; Mastectomy; Mastectomy, Modified Radical; Nalbuphine; Pain, Postoperative; Ultrasonography, Interventional

Cancer pain is a debilitating disorder of human breast cancer and a primary determinant of the poor quality of life, and relieving pain is fundamental strategy in the cancer treatment. However, opioid analgesics, like morphine and fentanyl, which are widely used in cancer pain treatment have been reported to enhance stem-like traits and epithelial-mesenchymal transition (EMT) of breast cancer cells. As such, it is vital to make the best choice of analgesic for breast cancer management.. MTT assays and colony formation assays were performed to examine tumor cell proliferation upon nalbuphine treatment. RT-PCR, western blot, flow cytometry, sphere formation, immunohistochemistry, transwell assays, wound healing assays and mouse xenograft were used to assess the biological effects of nalbuphine treatment.. Nalbuphine inhibited breast cancer cell growth and tumorigenesis, with little effect on noncancerous breast cell lines. Nalbuphine suppressed cancer stem-like traits and EMT in both breast cancer cells and mouse xenograft tumor tissues. Additionally, activation of AKT reversed the nalbuphine-induced inhibition of cancer stem-like properties, tumorigenesis and EMT.. Our results demonstrate a new role of nalbuphine in inhibiting cancer stem-like properties and EMT in addition to relieving pain, which suggests that nalbuphine may be effective in breast cancer treatment.

Topics: Animals; Breast Neoplasms; Cell Line, Tumor; Cell Movement; Cell Proliferation; Disease Models, Animal; Epithelial-Mesenchymal Transition; Female; Humans; Mice; Nalbuphine; Neoplastic Stem Cells; NF-kappa B; Proto-Oncogene Proteins c-akt; Signal Transduction; Xenograft Model Antitumor Assays