A PROSPECTIVE RANDOMISED COMPARATIVE STUDY TO EVALUATE EFFICACY, TOLERABILITY AND COST-EFFECTIVENESS OF TRANSDERMAL DICLOFENAC AND KETOPROFEN PATCHES FOR POSTOPERATIVE ANALGESIA IN UPPER LIMB FRACTURE FIXATION SURGERIES IN A TERTIARY CARE HOSPITAL

Post operative pain (POP) is a critical aspect after any surgery manifesting in 70-75% of patients as moderate to severe pain. Its management is an important public health concern worldwide, especially following orthopaedic surgery. The upper limb orthopaedic surgeries which include both bone and soft tissue, should have an appropriate analgesic modality to reduce delayed post operative function which increases the duration of hospital stay and occurrence of re-admission which impacts the socio-economic and quality of life of the patients.

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the commonly used drugs for POP relief throughout the world as they require less monitoring with fewer side effects. They are administered by oral, parenteral, inhalational, and transdermal routes. Transdermal patches provide prolonged and steady release of drugs with added advantage of avoiding first pass metabolism. Patient compliance is improved since it provides reduced dosage frequency with ease of administration and termination compared to oral route. Being non-invasive it allays the fear associated with parenteral routes. They are especially useful for post-op analgesia in surgeries where tissue dissection or expected pain is moderate such as upper limb fracture fixation surgeries.

Commonly used NSAIDs in this route are diclofenac and ketoprofen. Diclofenac is a relatively nonselective inhibitor of Cyclooxygenase (COX) whereas Ketoprofen is a nonselective COX and also Lipooxygenase inhibitor. This study is conducted as there is lack of data comparing the efficacy, tolerability, and cost-effectiveness of the transdermal patches of diclofenac and ketoprofen in post operative analgesia in upper limb fracture fixation surgeries.