To Evaluate the Efficacy and Hemodynamic Effects of Transdermal Buprenorphine Patch in Postoperative Pain Management in Abdominal Surgeries

Abstract

ABSTRACT
The present study was carried out in 120 Patients of age 20-50 years with ASA grade I & II of either sex. The following are the important observations done during the study: Patients receiving transdermal buprenorphine patch 20 microgm/hour 6 hours before surgery had better haemodynamic stability. Among General anaesthesia groups, the HR and SBP were lower in group A (20 mcg/h) at most of the study points. However, the DBP and MAP were slightly higher in group A (20 mcg/h) at most of the study points. RPP (HR*MAP) was lower in group A (20 mcg/h) at most of the study points, except during the initial 6 hours and at 72 hours. In patients undergoing surgeries under Regional Anaesthesia, it was observed that the group B (20 mcg/h) had slightly lower HR. The SBP, DBP and MAP were similar in both the groups. Similarly RPP (HR*MAP) was lower in group B at most of the study points. VAS scores were significantly lower with transdermal buprenorphine patch 20 microgm/hour in both general anaesthesia and regional anaesthesia groups. With respect to General Anaesthesia, it was observed that the scores were significantly lower in the group A (20mcg/h) at all points from 6 h to 72 h. Among the regional anaesthesia, group B was observed that the scores were significantly lower in at all points from 6 h to 72 h. Thus, Buprenorphine 20 mcg/ hr patch had lower VAS scores in both general and regional anaesthesia. In patients done under general anaesthesia, the frequency of rescue analgesia was 5.40±1.16 (group A). In patients done under Regional anaesthesia the frequency of rescue analgesia was 5.13±0.63 in group B. In patients done under general anaesthesia, the total dose of rescue analgesic required was to group C, 405.00±87.20 mgs. In patients done under Regional anaesthesia the total dose of rescue analgesic required group B 385.00±47.16 mgs. All the patients were cooperative, oriented and tranquil by 18 hours of post-operative period. Sedation score of 2 was achieved earlier with 20 micrograms patch in both general and regional anaesthesia groups. No major adverse effects were observed in any of the study groups. Transdermal buprenorphine in a dose of 20 micrograms/hour applied 6 hours prior to surgery provides good analgesia in patients undergoing surgeries with both general and regional anaesthesia, with lower pain scores ( less than 3, after 30 hours postoperative ) and lesser requirement of rescue analgesics (group A, 405.00±87.20 mgs. And group B, 385.00±47.16 mgs), without significant adverse effects. No incidences of bradycardia or hypotension were observed during the study.