Article
To evaluate the efficacy and safety of Buprenorphine 5 mg Patch in the immediate post op pain relief following Total Knee Replacement
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Authors
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Sanjay Londhe
- Holy Spirit Hospitall, Mumbai, India
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Ravi Shah
- Criticare Hospital, Mumbai, India
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Mugdha Oak
- Criticare Hospital, Mumbai, India
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Meghana Patwardhan
- Criticare Hospital, Mumbai, India
| Published: | October 22, 2019 |
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Outline
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Introduction and aim: The pain a patient experiences immediately following a TKR is always a concern both to the patient and the operative team. The NSAIDS also need to be used very cautiously in the TKR population group as most of them are in their seventies or eighties, many of them have acompromised renal function due to pre existent hypertension and/diabetes. Very large quantities of paracetaamol are also not risk free as cases of hepato-toxicity are being reported. The purpose of this study is to evaluate the safety and efficacy of Buprenorphine, 5 mg trans dermal patch in the management of pain in the immediate post operative (TKR) period
Material and methods: Successive 200 patients undergoing TKR ware evaluated in the study. The patients were divided in group A which received Buprenorphine patch (immediately post op) in addition to conventional analgesics (iv paracetamol and iv diclofenac ) and group B which only received conventional iv analgesics. Group A and B both had 85 female patients and 15 male patients. The mean age of male and females in group A was 71 years and 69 years respectively. The mean age of males and females in group B was 73 years and 67 years respectively. Both groups had equal no of unilateral and bilateral TKR patients. Unilateral TKR were done under spinal anesthesia and supplanted with femoral or adductor canal block. Bilateral TKR were done under combined spinal and epidural anesthesia.
Results: The pain relief as experienced by the patient in group A was significantly better than group B ( As measured by VAS). Also the requirement of injectable pain killers like iv paracetamol, iv diclofenac and iv tramadol was significantly less in the group A as compared to group B. The Buvalor patch 5 mg was well tolerated by almost all the patients except one female aged 79 years who experienced some respiratory difficulty and hence patch had to be removed.
Conclusion: This study clearly demonstrates the advantage of using buprenorphine trans dermal patch in the management of immediate post TKR surgery pain. It substantially reduces the requirement of NSAIDS, large doses of iv paracetamol as well as injectable opioids. We conclude that the use of buprenorphine patch in the post TKR surgery is safe as well as very effective in reducing pain and preventing complications like nephrotoxicity and hepatotoxicity
