Abstract

Open nephrectomies are commonly seen surgeries in renal transplant and renal tumours are associated with moderate to severe pain. These patients need good post-operative analgesics for early rehabilitation and mobilisation. Transdermal buprenorphine which is used in chronic pain management has rarely been studied in acute pain management. The aim of this study was to compare the efficacy and safety of transdermal buprenorphine patch to injection tramadol for post-operative analgesics following open nephrectomy surgeries. Methods: Sixty adult aged 18-60 years with American Society of Anaesthesiology physical status I/II scheduled for open nephrectomy surgeries under general anaesthesia were divided in two groups. Group A received Transdermal buprenorphine patch 10 mcg/hour applied 12 hours before surgery and Group B received injection tramadol 100 mg just after extubation. Injection Paracetamol 1 gram intravenously was given as rescue analgesia. Pain score at rest, on movement, total doses of rescue analgesia and side effects were compared in both the groups for seven days. Results: There was significant low visual analogue scale (VAS) score in group A compare to group B at rest and on movement (p<0.001). The requirement of rescue analgesia was significantly lower in group A (14.3% vs 100%). The side effects like nausea, vomiting, drowsiness was lower in group A compared to group B. Group A has better satisfactory scores compared to Group B. Conclusion: Transdermal buprenorphine patch can be safely used for post-operative analgesia and is more efficacious in reducing post-operative pain with fewer side effects compared to injection tramadol

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