A randomized comparative study to evaluate efficacy and safety of transdermal buprenorphine patch with transdermal fentanyl patch as Pre-emptive analgesia in postoperative pain control in patients undergoing mastectomy surgery

Abstract

Introduction: Amongst the various modes of delivery, transdermal route has several potential benefits over other routs of administration for perioperative analgesia. These include noninvasive dosing, better absorption and lack of first pass metabolism. It provides steady and continuous drug delivery resulting in steady plasma concentration. Experimental approach: 60 patients undergoing mastectomy surgery were randomly divided in 2 groups (n=30). Group A received buprenorphine 10 mcg/h TDS and group B received 25 mcg/h fentanyl TDS, 4 hours prior to surgery. Patients were followed for three days for postoperative pain relief and adverse effects. Major findings: The mean level of VAS was significantly lower in group B. The mean level of sedation score was significantly lower in Group B. 13.3% patients in group A required single dose of rescue analgesic while 0.00% in group B. 18% patient in fentanyl group and 13.3% patients in buprenorphine group experienced some adverse effects. Conclusion: Fentanyl and buprenorphine TDS were safe and effective in controlling postoperative pain. Fentanyl is better than buprenorphine in this respect.