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A prospective comparitive study of transdermal patches for post operative pain management in laprotomy surgeries: efficacy and rescue analgesic requirements

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Original Article

Author Details : Uday Gollamudi*

Volume : 11, Issue : 4, Year : 2024

Article Page : 557-564

https://doi.org/10.18231/j.ijca.2024.100

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Abstract

Background: The word laparotomy is derived from the Greek words lapara, meaning flank, and tomy, meaning cut. In surgical practice, this translates to a big cut in the abdomen to gain access to the peritoneal cavity. Pain continues to be a significant problem following laparotomy. Transdermal drug delivery has several advantages over oral and parenteral administration.
Aim & Objective: A randomized comparative study to evaluate and compare the efficacy of various transdermal patches (Fentanyl, Buprenorphine, Diclofenac and Ketoprofen) for post operative pain relief in laparotomy surgeries.
Materials and Methods: A total 80 patients of ASA grade I & II with age between 20-60 of either sex who were undergoing laparotomy surgery were randomly divided into 4 groups Group F (Fentanyl), Group B (Buprenorphine), Group D (Diclofenac) & Group K (Ketoprofen) using a computer-generated randomization list. Anesthetic procedure was standardized in all groups. group F received 25µg/hr Fentanyl patch, group B received 20µg/hr Buprenorphine patch, group D received 200mg Diclofenac patch and group K received 20mg Ketoprofen patch, applied postoperatively. Patients were followed for 72 hours postoperatively and pain was assessed using the visual analogue scale (VAS) and Sedation was assessed using Ramseys sedation scoring system.
Results: Group D (Diclofenac) and Group K (Ketoprofen) required more frequent rescue analgesics and daily patch replacements. Group F (Fentanyl) had the least analgesic requirements, with a single patch lasting for 72 hours. Group B (Buprenorphine) had similar duration of action, but produced more sedation as compared to Group F (Fentanyl). VAS score and pain relief were highest in Group F (Fentanyl), with minimal side effects when compared to other groups.
Conclusion: The transdermal fentanyl patch provides effective post operative analgesia with minimal side effects and lower rescue analgesic requirements over 72 hours.
 

Keywords: Fentanyl, Buprenorphine, Diclofenac, Ketoprofen, Rescue analgesia, Laparotomy surgery, Patch, Sedation, VAS.

How to cite : Gollamudi U, A prospective comparitive study of transdermal patches for post operative pain management in laprotomy surgeries: efficacy and rescue analgesic requirements. Indian J Clin Anaesth 2024;11(4):557-564

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