A COMPARATIVE STUDY OF TRANSDERMAL BUPRENORPHINE WITH TRANSDERMAL FENTANYL FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING POSTERIOR STABILIZATION OF LUMBAR SPINE

Background and Objectives: Posterior stabilization of lumbar spine is associated with high degree of postoperative pain and hence, effective analgesia is a priority in this patient population as inadequate management of acute pain in the long run can result in chronic pain. Newer modalities of analgesia that are safe, non-invasive and user friendly are constantly being investigated. One such example of an analgesic is the transdermal system of opioid drugs. The pharmacological and clinical profiles of buprenorphine and fentanyl make them suitable for transdermal use. We conducted this study to find out which among the two is more effective for postoperative analgesia and which drug patch has a better side-effect profile. Methods: Sixty patients who gave their informed consent, aged between 18-60 years undergoing elective posterior stabilization of lumbar spine, were divided into two groups of 30 each and were assigned to receive either a fentanyl patch (25 μg/hour) or a buprenorphine patch (10μg/hr). Vitals were closely monitored in the postoperative period and if the VAS scores were >4, rescue analgesia was administered. Results: VAS scores were significantly lower in the group that received fentanyl patch. Those who received the buprenorphine patch experienced more frequent breakthrough pain and thus needed more rescue analgesia. However, fentanyl group experienced more nausea. Conclusion: The study hence concluded that for postoperative analgesia, transdermal fentanyl holds promise. More studies on a larger scale need to be conducted to consolidate this finding.