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 surgery
which requires multimodal analgesia postoperatively as it requires excellent postoperative analgesia for early orthopedic
rehabilitation as well. Transdermal opioid patches is a part of this multimodal analgesia regimen for postoperative pain
relief.
Material and method: The study was conducted after Institutional Ethical committee approval, and informed written
consent taken from all participants. 60 patients enrolled for this study of ASA 1 and ASA 2 grade, either gender posted
for 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 analgesic
noted, 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 the
post-operative period. 0.0005 is the p-value. Pruritus was more common in group F which was statistically significant as
compared to the group a. Pruritus was seen in six patients in group F but only two patients in Group B. Group F showed
more incidence of nausea/vomiting as well as more requirement of antiemetic as compared to other groups, but it was
not statistically significant.
Conclusion: In lower limb arthroscopic procedures, buprenorphine patch was shown to be more effective than fentanyl
patch for postoperative pain, with no increased hemodynamic instability or side effects.