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Comparative study of the efficacy of fentanyl and buprenorphine transdermal patch for post-operative analgesia in lower-limb orthopedic surgery

Prabhatirani Mishra, Saubhagya Kumar Hota, Jyoshna Mishra, Jagnyaseni Panda.


Background: Opioids are frequently employed as part of a comprehensive perioperative pain management strategy. Among the various routes of administering analgesics, transdermal drug delivery systems offer advantages over oral and parenteral methods. Transdermal opioid patches represent a contemporary approach to managing post-operative pain due to their non-invasiveness, prolonged efficacy, and reduced reported side effects.

Aims and Objectives: This study aimed to assess the effectiveness of post-operative pain reduction using buprenorphine and fentanyl patches in patients undergoing surgeries for lower limbs in the department of orthopedics.

Materials and Methods: This comparative and cross-sectional study included 80 adult patients undergone lower-limb surgeries for orthopedic conditions. They are randomly divided into two groups. In Group B (n = 40), buprenorphine patches at 10 μg/h were applied, while in Group F (n = 40), fentanyl patches at 25 μg/h were applied 12 h before surgery. Mean visual analog scale (VAS) scores, sedation scores, total rescue analgesic requirements, and any perceived or reported adverse effects were assessed over a 72-h post-operative period.

Results: The age, body weight, and duration of surgeries between the two groups were similar. The VAS scores indicated lower pain levels in the group receiving fentanyl patch compared to the group of patients receiving buprenorphine patch. The total consumption of the analgesic injection was lower in the group receiving the fentanyl patch. Sedation scores and adverse effects were more prevalent in patients receiving buprenorphine patches compared to the group receiving fentanyl patches.

Conclusion: For pain management in patients undergoing lower-limb surgeries, the fentanyl transdermal patch demonstrates greater effectiveness compared to the transdermal buprenorphine patch. Hence, doctors may think using it for their patients for better pain management and well-being of the patients.

Key words: Post-operative Analgesia; Buprenorphine Patch; Fentanyl Patch; Transdermal Drug Delivery System; Visual Analog Scale

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