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. 2022 Jun 25;56(8):1363-1369.
doi: 10.1007/s43465-022-00668-7. eCollection 2022 Aug.

Comparison of Efficacy and Safety of Transdermal Buprenorphine Patch and Conventional Analgesics in Intra-capsular Femur Neck Fracture Post Hemiarthroplasty

Sanjay Bhalchandra Londhe  1 , Meghana Patwardhan  2 , Ravi Vinod Shah  2 , Mugdha Oak  2 , Asit Shah  3 , Nicholas Antao  1 , Rahul Khot  2
Affiliations

Comparison of Efficacy and Safety of Transdermal Buprenorphine Patch and Conventional Analgesics in Intra-capsular Femur Neck Fracture Post Hemiarthroplasty

Sanjay Bhalchandra Londhe et al. Indian J Orthop. .

Abstract

Background: One of the most common fractures in the elderly population is a fracture of the neck of femur. Effective post-operative analgesia is a major challenge. Age-related co-morbidities restrict the choice of analgesics. The purpose of this study was to compare the efficacy and safety of transdermal buprenorphine [TDB] patch and conventional analgesics following hemiarthroplasty for intra-capsular fracture neck of femur.

Materials and methods: This was a prospective, randomized control study done in 60 patients undergoing hemiarthroplasty for intra-capsular fracture neck of femur over a period of 2 years. Patients were randomized in 2 groups. Group A received a combination of IV paracetamol and tramadol for first 48 h followed by oral formulation. In Group B patients, a transdermal buprenorphine patch of 5 mcg/h was applied at the beginning of surgery and was continued 2 weeks post-operative.Pain score by VAS was observed both at rest and on movement and followed up till 14 days post-operative. Primary target was to maintain a VAS ≤ 4. Rescue analgesic was given if the VAS was ≥ 6. Secondary targets were number of rescue analgesics required, adverse reactions and complications if any.

Results: Group B had significantly lower pain scores at rest and during movement [p value 0.0012 to ≤ 0.0001], so was rescue analgesia requirement. No significant side effects were seen in TDB group.

Conclusion: TDB patch is safe and provides superior analgesia and compliance as compared to conventional analgesics in the post-operative period in proximal femur fracture surgeries.

Keywords: Conventional analgesics; Hemiarthroplasty; Post-operative; Proximal femur fracture; Transdermal buprenorphine patch.

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Conflict of interest statement

Conflict of interestThe authors declare no financial conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Pain intensity as measured by VAS at rest. Horizontal legend describes time frame measured in hours for the first 72 h and days thereafter to a total of 14 days
Fig. 2
Fig. 2
Pain intensity as measured by VAS on movement. Vertical legend describes the pain intensity measured on a 11-point VAS scale where 0 = no pain and 10 = worst imaginable pain
See this image and copyright information in PMC

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