After laparatomy transdermal fentanyl and IV. patient controlled fentanyl comparison analgesic effect

Today, despite the usage of several methods and analgesic drugs for pain therapy, studies and discussions on this topic never seem to end. The method called transdermal fentanyl (TDF) patching is an alternative one which is an easy and a noninvasive application for patients. Therefore, this study intends to demonstrate whether TDF patching is an effective and an acceptable method for postoperative pain therapy or not.Upon approval of this prospective randomized study at the ethics board of Gaziantep University ASA I-II-III, 60 patients aging between 18 and 65 who had laparatomy were selected as test subjects. No premedication was applied to any patient. Patients were randomyl separated into two groups, each consisting of 30 patients(n=30). TDF patching (50µg/hour) was applied to the first group, starting 12 hours before the operation and quitted 24 hours after it. Postoperative patient-controlled iv fentanyl analgesia was applied the second group (HKA) at the PACU. If the pain appears (VAS≥4) 100 mg tramadol performed for group TDF. Patients from both groups TDF and HKA were monitored clinically during their perioperative periods.. Demographics data, postoperative hemodynamic parameters, Ramsey Sedasion Scales (RSS) and Visual Analgesic Scores (VAS) , additional analgesic agents consumption quantities and their side effects for each patients of both groups were recorded. Statistically, there was no significant difference between two groups in terms of demographics, hemodynamics and side effects. Group HKA had better statistics (p˂ 0,05) than group TDF in terms of postoperative VAS at rest at 2nd, 4th, 6th, 12th and 24th hours(excluding the first hour). The demand for additional analgesic agents (in postoperative period at including 1st, 2nd, 6th and 24th hours, but excluding 4th hours) among group TDF was statistically (p˂ 0,05) more than group HKA. It was concluded that; In terms of VAS assessment HKA is a better method than TDF patching for patients in postoperative period. However; When in need, TDF patching can be used, with tramadol support, as an alternative method for patient-controlled analgesy.