Comparison of postoperative analgesic efficacy of transdermal and epidural buprenorphine following major abdominal surgeries: a prospective randomized study

Abstract

Introduction A transdermal delivery system provides steady and continuous drug delivery as compared with epidural route. The aim of the present study was to compare the efficacy of transdermal and epidurally administered buprenorphine in providing adequate postoperative analgesia in patients undergoing major abdominal surgeries. Patients and methods The present study was a prospective, randomized, open-label study conducted in 30 patients aged between 18 and 70 years undergoing major abdominal surgeries. Patients were randomized equally into two groups. T group received a transdermal buprenorphine 10-mg patch, with a delivery rate of 10 μg/h, which was applied ∼20–24 h before surgery. On day of the surgery for patients belonging to E group, an epidural catheter was placed at the start of the surgery and buprenorphine 150 μg in 10-ml saline was given epidurally. All patients received general anesthesia following standardized anesthesia protocol. In the postoperative period, pain relief was checked using numerical rating scale. Results Mann–Whitney U test and independent t test were used as applicable. Numerical rating score was significantly higher in group T at 0, 6, 12, 18, 24, and 30 h as compared with group E. It became comparable at 36, 42, and 48 h. The need for rescue analgesia was significantly higher in group T as compared with group E. Conclusion Epidurally administered buprenorphine is superior in providing adequate analgesia in the early postoperative period in patients undergoing major abdominal surgeries as compared with the transdermal route.