Comparisons of Transdermal Buprenorphine Patch versus Transdermal Fentanyl patch for postoperative analgesia in lower limb orthopedic surgery

Abstract

Background: Postoperative pain are acute, moderate to severe type. Lower limb orthopedic surgeries are subset of surgerywhich requires multimodal analgesia postoperatively as it requires excellent postoperative analgesia for early orthopedicrehabilitation as well. Transdermal opioid patches is a part of this multimodal analgesia regimen for postoperative painrelief.Material and method: The study was conducted after Institutional Ethical committee approval, and informed writtenconsent taken from all participants. 60 patients enrolled for this study of ASA 1 and ASA 2 grade, either gender postedfor lower limb orthopedic procedure. The patients were assessed preoperatively and patches applied 6hrs prior surgery.All patients received paracetamol 1gm as rescue analgesic. Total duration of analgesia, requirement additional analgesicnoted, panic evaluated with VAS and any side effects also noted for 3 days .Results: The visual analogue scale shows significant values in the fourth [Group B] and eight hours [Group F] hours of thepost-operative period. 0.0005 is the p-value. Pruritus was more common in group F which was statistically significant ascompared to the group a. Pruritus was seen in six patients in group F but only two patients in Group B. Group F showedmore incidence of nausea/vomiting as well as more requirement of antiemetic as compared to other groups, but it wasnot statistically significant.Conclusion: In lower limb arthroscopic procedures, buprenorphine patch was shown to be more effective than fentanylpatch for postoperative pain, with no increased hemodynamic instability or side effects.