Evaluation of Transdermal Fentanyl Patch for Postoperative Analgesia in Patients Undergoing Total Laparoscopic Hysterectomy (Code-T0312)

Introduction: Effective postoperative pain management is crucial in surgical care, particularly
following total laparoscopic hysterectomy (TLH). Traditional methods such as intravenous
patient-controlled analgesia (IV-PCA) using opioids like tramadol and fentanyl are commonly
employed. The transdermal fentanyl patch (TFP), initially used for chronic cancer pain, has
emerged as an alternative for acute postoperative pain management. This study evaluates the
efficacy of TFP compared to intravenous tramadol for pain relief following TLH.
Aims and Objectives: To assess the analgesic efficacy of a transdermal fentanyl patch (TFP)
(25 μg/hour) applied 10–12 hours before surgery versus intravenous tramadol for postoperative
pain control in TLH patients.
Methods: This randomized comparative study included 20 patients undergoing elective TLH
under general anesthesia. Patients were divided into two groups: Group F received TFP (25
μg/hour) applied 10–12 hours preoperatively, while Group T received intravenous tramadol (50–
100 mg IV BD). Pain severity was assessed using the Numeric Rating Scale (NRS) at 6, 12, 24,
and 48 hours postoperatively. Ambulation, sedation, and nausea/vomiting (N/V) scores were also
recorded.
Results: TFP provided significantly better pain relief at 6, 12, and 24 hours postoperatively
compared to tramadol. By 48 hours, pain scores were comparable. Patients in the fentanyl group
exhibited improved ambulation and lower incidences of nausea and vomiting. Sedation scores
remained similar in both groups.
Conclusion: TFP is an effective and well-tolerated option for managing postoperative pain in
TLH patients, offering superior pain control, enhanced recovery, and a better side effect profile
compared to intravenous tramadol.
Keywords: Transdermal fentanyl, postoperative pain, laparoscopic hysterectomy, analgesia,
tramadol, pain management.