Postoperative Pain Management in Lower Limb Surgery Patients using Transdermal Buprenorphine and Diclofenac Formulation

Abstract

Background: The present study was carried out to determine the difference in the effectiveness of buprenorphine and diclofenac transdermal patches in attenuating postoperative pain, following lower limb orthopedic surgeries in a tertiary care teaching hospital in Kerala, South India. Methods: 88 patients who underwent lower limb orthopedic surgeries under spinal anesthesia were included in this simple randomized single-blind study. Group A received transdermal Buprenorphine 10 mcg/h patch and Group B received transdermal Diclofenac 200 mg patch. Both patches were, applied 30 minutes before spinal anesthesia and the intensity of pain was determined using, Visual Analog Scale (VAS) and Faces Pain Scale (FPS-R). The pain scores at every 4th hour for 24 hours were measured and recorded for all patients. Side-effects and patient satisfaction were checked and evaluated. Results: 39 patients (44.31%) out of a total of 88 patients required rescue analgesia. Mean and maximum VAS and FPS scores of patients in the Diclofenac group were higher. Adverse effect: Buprenorphine group complained of nausea (22.7%), headache (15.9%), and dizziness (13.6%) while Diclofenac group complained of nausea (18.2%). Majority of patients in both groups expressed their satisfaction with transdermal patch therapy as good (93.18%). Conclusion: Transdermal Buprenorphine patch was more effective in attenuating postoperative pain than transdermal Diclofenac patch, following lower limb orthopedic surgeries.