Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Maxwell L, White S. Anesthetic management of patients with hip fractures: An update. Crit Care Pain. 2013;13:179–183.
    1. White SM, Rashid N, et al. An analysis of renal dysfunction in 1511 patients with fractured neck of femur: The implications for peri-operative analgesia. Anaesthesia. 2009;64:1061–1065. doi: 10.1111/j.1365-2044.2009.06012.x. - DOI - PubMed
    1. Griffiths R, Alper J, et al. Management of proximal femoral fractures 2011: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2012;67:85–98. doi: 10.1111/j.1365-2044.2012.07144.x. - DOI - PubMed
    1. Pergolizzi JV, Jr, Scholten W, et al. The unique role of transdermal buprenorphine in the global chronic pain epidemic. Acta Anaesthesiologica Taiwanica. 2015;53:71–76. doi: 10.1016/j.aat.2015.06.001. - DOI - PubMed
    1. Setti T, Sanfilippo F, Leykin Y. Transdermal buprenorphine for postoperative pain control in gynecological surgery: A prospective randomized study. Current Medical Research and Opinion. 2012;28:1597–1608. doi: 10.1185/03007995.2012.719864. - DOI - PubMed

LinkOut - more resources