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ORIGINAL ARTICLE
Year : 2018  |  Volume : 32  |  Issue : 1  |  Page : 46-50

Comparison of efficacy and safety of transdermal buprenorphine patch applied 48 versus 72 hours preoperatively in providing adequate postoperative analgesia following major abdominal surgeries


Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

Correspondence Address:
Dr. Sunil Rajan
Department of Anaesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala 682041
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpn.ijpn_4_18

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Introduction: A transdermal drug delivery system provides steady and continuous drug delivery. As the onset of action is delayed, it has to be applied preoperatively to provide optimal postoperative analgesia. Aim: To compare the efficacy and safety of transdermal buprenorphine patches applied 48 and 72 h preoperatively in providing adequate postoperative analgesia following major abdominal surgeries and the incidence of side effects. Materials and Methods: This prospective randomized, double-blinded study was conducted in a tertiary care institution. Thirty patients undergoing laparotomy were recruited. Group A (n = 15) received a transdermal buprenorphine 10 mg patch with a delivery rate of 10 μg/h, which was applied approximately 48 h before surgery, whereas in group B (n = 15) buprenorphine 10 mg patch was applied 72 h preoperatively. All patients received general anesthesia following standardized protocol. Postoperative pain was assessed using numerical rating scale (NRS). The Mann–Whitney U test and independent t-test were used for statistical analysis. Results: NRS was significantly high in group A for up to 30 h postoperatively as compared to group B. From 36 to 48 h, it was comparable. The need for rescue analgesia was significantly high in group A as compared to group B. Significant number of patients in group B experienced nausea and vomiting (53.33% vs. 26.67%) and sedation (20% vs. 13.33%) in the preoperative period. Conclusion: Transdermal buprenorphine patch applied 72 h preoperatively provided better analgesia than the one applied 48 h before surgery. However, its preoperative use in patients without painful conditions predisposes them to develop side effects.


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