A Comparative Study to Evaluate Efficacy of Post-Operative Analgesia of Fentanyl Transdermal Patch Versus Ketoprofen Patch in Major Abdominal Surgeries Performed under General Anaesthesia in North Eastern India

Abstract

BACKGROUND Safe & efficacious post-operative pain control is a significant aspect of patient treatment in the part of an anaesthesiologist. The present study was carried out to determine the efficacy and safety of fentanyl transdermal patch and ketoprofen patch for post-operative analgesia in major abdominal surgeries under general anaesthesia in a tertiary care teaching hospital in Assam, India. METHODS After ethical approval, 60 patients of either sex, aged between 18 - 60 years, American Society of Anaesthesiologists (ASA) physical status I or II posted for major abdominal surgeries under general anaesthesia were included in this prospective, single blinded, randomized, comparative study. The patients were randomly allocated to receive either ketoprofen transdermal patch (Group K n1 = 30) or fentanyl transdermal patch (Group F n2 = 30) 4 hours prior to the surgery. Pain was assessed post-operatively after an interval of every 4 hours for 24 hours using visual analogue scale (VAS), verbal rating scale (VRS). Sedation was assessed at same intervals post-operatively using Ramsay sedation scale. RESULTS During the first 4 and 8 hours following surgery, the difference in mean VAS, VRS observed between the two groups were found to be statistically non-significant (p > 0.05). Whereas, during 12 hours, 16 hours, 20 hours, and 24 hours following surgery, the difference in mean VAS, VRS observed between the two groups was found to be statistically significant (p < 0.05). No patient in fentanyl group had score of more than 3 in Ramsay sedation scale during the study. Rescue analgesia was required in 3 patients (10 %) of the ketoprofen group whereas no patient in fentanyl group needed rescue analgesia. CONCLUSIONS Fentanyl transdermal patch (25 mcg/hr) applied 4 hours prior to surgery, had an edge over ketoprofen transdermal patch (100 mg) in attenuating post-operative pain and showed comparatively longer duration of action, without showing any serious side effect. KEY WORDS Transdermal Ketoprofen, Fentanyl, Analgesia