Efficacy of Transdermal Buprenorphine Patch in Postoperative Pain Management in Oral and Maxillofacial Surgery.

ABSTRACT

Aim: To evaluate the therapeutic efficacy of transdermal Buprenorphine patch in postoperative pain management in Major Oral and Maxillofacial surgeries done under general anesthesia. Materials and Method: A total number of 100 subjects, both males and females in the age group of 18-60 years were included in the study. At the screening visit, a brief medical history was recorded for each prospective subject. The subject was selected according to the inclusion and exclusion criteria and consent was taken before placing the patch. For a period of 7 days, 10 mg Buprenorphine patch was placed on the skin of the patient for 3 h before the surgery. Analgesic efficacy was recorded for the next 7 days by using visual analogue scale (hereinafter refered to as "VAS"). If the VAS score was above 5, the rescue analgesia inj. Dynapar I.V was administered to the patient. Results: The mean VAS score in females 4.4, was high when compared to males 3.9, which would suggest that the patch was more effective in males compared to females. Trauma patients showed mean VAS score of 3.9 and pathology patients showed a mean VAS score of 4.1. 36% of the patients required additional analgesics as the VAS score was more than 5. 20% of patients between age group of 20-30 years required additional analgesics, 66.7% in 31-40yrs, 0% of 41-50yrs and 13.3% in 51-60yrs required additional analgesics. 24% of the females patients required 37 additional analgesics compared to the 12% in male patients. 21.6% of patients treated for pathology required additional analgesics compared to the 8.2% in trauma patients. Thus, the sensitivity of this study was 94.1% and specificity was 33.3%. Conclusion: Buprenorphine has high analgesic potential, good safety profile, ease of opioids switches and reversibility by µ- antagonist. Transdermal route is cost effective and has increased patient compliance and ease of handling with less adverse effects. Thus, the efficacy of transdermal buprenorphine in postoperative pain management was good.