COMPARATIVE EVALUATION OF ANALGESIC EFFICACY OF TRANSDERMAL PATCHES OF BUPRENORPHINE AND FENTANYL IN MANAGEMENT OF POSTOPERATIVE PAIN AFTER LOWER LIMB SURGERIES: A RANDOMIZED CONTROLLED STUDY

Abstract

Background: “Postoperative pain management remains a significant challenge, as inadequate analgesic relief can delay rehabilitation, prolong hospital stays, and contribute to hemodynamic and psychosocial issues. Transdermal drug delivery systems (TDS) offer a non-invasive alternative to traditional needle injections, providing controlled drug release and enhanced patient compliance. Buprenorphine and fentanyl, two lipophilic opioid analgesics, have shown promise in various clinical settings for postoperative pain management. Aim: This study aimed to compare the analgesic efficacy of buprenorphine and fentanyl transdermal patches in managing postoperative pain following lower limb surgeries. Materials and Methods: A randomized controlled trial was conducted with 58 patients undergoing lower limb orthopedic surgeries under spinal anesthesia. Patients were randomly assigned to either Group A (buprenorphine transdermal patch, 20 μg·h‐1, n=28) or Group B (fentanyl transdermal patch, 25 μg·h‐1, n=28). Pain scores were measured using the Numerical Rating Scale (NRS) at 1, 2, 4, 8, 12 hours, and every 12 hours up to 72 hours postoperatively. Rescue analgesia was provided with diclofenac and tramadol if NRS >4. Statistical analysis was performed using SPSS v23.0, with a p-value <0.05 considered significant.” XIV Results: The mean age and baseline vital parameters were comparable between the two groups (p>0.05). Complete blood picture, random blood sugar levels, and renal parameters showed no significant differences. NRS scores at various time points were similar between the groups (p>0.05). The need for rescue analgesia was comparable overall, but at the 4th hour, Group B (fentanyl) required significantly more rescue analgesia (21.4%) compared to Group A (buprenorphine) (3.6%). Conclusion: Both buprenorphine and fentanyl transdermal patches effectively managed postoperative pain with similar efficacy in most measured intervals. However, buprenorphine was associated with a lower requirement for rescue analgesia at the 4th postoperative hour, suggesting a potential advantage in early pain management. Further research with larger sample sizes is necessary to confirm these findings.