TDB (Transdermal buprenorphine), a widely used patch for the management of chronic pain, has been rarely studied in an acute postoperative setting. The study evaluating Buprenorphine transdermal patch after TKA (Total knee arthroplasty) surgery depicted that TDB patch is more efficacious in diminishing postoperative pain. It can be safely used and provides better satisfaction scores, superior analgesia with fewer systemic side effects when compared to conventional analgesics.

This prospective randomized study aimed to compare the safety and efficacy of a TDB patch to conventionally used analgesics for post-operative analgesia after TKR surgeries.

From January 2015 to May 2018, the study enrolled 200 patients (aged 60-75 years) undergoing TKA (total knee arthroplasty) surgery under neuraxial anesthesia. All patients were given periarticular local anesthetic infiltration and epidural/femoral nerve block infusion for 72 hours postoperatively. Group A received the TDB patch 5 mcg applied at the end of surgery. Group B received paracetamol and tramadol combination. Intravenous diclofenac was given as rescue analgesia to all the patients. Using the numerical rating scale score, pain scores at rest, on movement, and side effects, if any, were compared over 7 days.

In group A, the pain scores at rest and on movement were considerably lower as depicted in Figure 1 and 2:

Rescue analgesia requirement was also found to be remarkably less in this group. Only 1 patient had respiratory depression, and 3 patients had local erythema. Satisfaction scores were also much more for

Group A (mean 4.45 ± 0.11) compared to Group B (mean 3.6 ± 0.51) as depicted in Figure 3: 

Transdermal buprenorphine is safe, effective, predictable, and economical for postoperative analgesia following TKR surgery.