Comparative study between transdermal buprenorphine patch 5 mcg/hour and 10 mcg/hour in post-operative pain management administered pre-emptively in laparoscopic surgeries under general anaesthesia

Postoperative pain management is an essentialcomponent for patient undergoing major surgery. Adequate pain management is achallenge to the anaesthesiologists as there are many adverse effectsassociated with pain physiologically and psychologically which can hamper thenormal recovery process.

The pain signaltransmission evoked by tissue damage leads to sensitization of the peripheraland central pain pathways. This sensitization can be prevented by blocking thepain signal transmission completely from the surgical site.

Pre-emptiveanalgesia is a treatment to reduce this sensitization which is initiated beforesurgery. Due to this protective effect on the nociceptive system, pre-emptiveanalgesia has the potential to be more effective than a similar analgesictreatment initiated after surgery. This helps to reduce immediatepost-operative pain and reduces the total amount of analgesics required the inpost-operative period.

Buprenorphine is a opioid analgesicthat has partial agonistic action at µ receptors and antagonistic action on κ receptor.It is a synthetic thebaine congener. It is a highly lipid-soluble µ analgesicwith great analgesic potency. It is 50 times more potent than morphine but withlower intrinsic activity and has ceiling effect. The onset of action is slowerand duration of action is longer. After a single dose, analgesia lasts for 6–8hours. Transdermal buprenorphine provides a non-invasive methodof drug release at a controlled rate. It ensures constant and predictable serumbuprenorphine levels over a prolonged period. Buprenorphine is homogenouslyincorporated in a solid polymer matrix patch which is applied to the skin. Theadhesive buprenorphine patch is non-invasive, simple and compliant method ofdrug delivery. It slowly and continuously releases the drug into the systemiccirculation. These characteristics suggest that transdermalbuprenorphine may be useful in the postoperative pain management for patientsundergoing laparoscopic surgeries under GA

 The study is conceptualized to comparethe intensity of pain relief of pre-emptively administered transdermal buprenorphinepatch 5 mcg/hr with 10 mcg/hr in post-operative analgesia.