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. 2017 Nov;61(11):923-929.
doi: 10.4103/ija.IJA_118_17.

Efficacy of transdermal buprenorphine patch on post-operative pain relief after elective spinal instrumentation surgery

Saikat Niyogi  1 , Pratibha Bhunia  2   3 , Jisnu Nayak  1   4 , Sankari Santra  5 , Amita Acharjee  1 , Indrani Chakraborty  1
Affiliations

Efficacy of transdermal buprenorphine patch on post-operative pain relief after elective spinal instrumentation surgery

Saikat Niyogi et al. Indian J Anaesth. 2017 Nov.

Abstract

Background and aims: Transdermal buprenorphine patch (TDB) is increasingly used for chronic pain management because of non-invasive dosing, longer duration of action and minimal side effects. However its role in acute post-operative pain management for spinal instrumentation surgery is not well established. The aim of this study was to evaluate the analgesic efficacy of buprenorphine patch for postoperative pain relief in patients undergoing spinal instrumentation surgery.

Methods: In this randomised, placebo-controlled, double-blinded, prospective study, 70 adult patients undergoing elective spinal instrumentation surgery were randomly allocated into two groups-TDB Group (buprenorphinepatch) and TDP Group (placebo patch). Time to first rescue analgesic requirement was the primary outcome. All patients also were monitored for total rescue analgesic requirement, drug-related adverse effect and haemodynamic status till 48 h after surgery. Statistical analysis was carried out using student independent t-test if normally distributed or with Mann-Whitney U-test if otherwise.

Results: Time to first post-operative rescue analgesic (tramadol) requirement was much delayed in TDB Group than TDP Group (708.0 ± 6.98 min vs 54 ± 0.68 min, P < 0.001) and the total tramadol requirement was higher in TDB Group (490.60 ± 63.09 averagevs. 162.93 ± 63.91 mg, P < 0.001). Intra-and post-operative haemodynamic status was also stable in TDB Group without any adverse event.

Conclusion: A TDB patch (10 μg/hour) applied 24 hours before surgery can be used as a postoperative analgesic for lumber fixation surgery without any drug-related adverse effect.

Keywords: Buprenorphine patch; post-operative analgesia; rescue analgesia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The CONSORT transparent reporting of trial - flow of patients in the trial. TDB – Transdermal buprenorphine; TDP – Transdermal placebo
Figure 2
Figure 2
Comparison of postoperative heart rate/minute between two groups. Statistically significant change (P<0.05) in heart rate was found (Student's unpaired t test) among the groups of patients at all time intervals. TDB – Transdermal buprenorphine; TDP – Transdermal placebo
Figure 3
Figure 3
Comparison of postoperative systolic blood pressure between two groups. Statistically significant change (P<0.05) in SBP was found (Student's unpaired t test) among the groups of patients except in 5th hr. In TDB SBP was satisfactorily in normal range but lower than that of TDP group. SBP – Systolic blood pressure, TDB – Transdermal buprenorphine; TDP – Transdermal placebo
Figure 4
Figure 4
Comparison of postoperative diastolic blood pressure between two groups. Statistically significant change (P<0.05) in DBP was found (Student's unpaired t test) among the groups of patients. In TDB group -DBP was satisfactorily in normal range but lower than that of placebo group. DBP – Diastolic blood pressure, TDB – Transdermal buprenorphine; TDP – Transdermal placebo
See this image and copyright information in PMC

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