STUDY ON COMPARISON BETWEEN ORAL PARACETAMOL AND TRANSDERMAL FENTANYL FOR POSTOPERATIVE PAIN RELIEF IN PATIENTS UNDERGOING ELECTIVE DAYCARE SURGERY FOR INGUINAL HERNIA IN KAPV MEDICAL COLLEGE,TRICHY

DR.SRI HARI; DR.JOHN AMALAN; DR.D.SIVAKUMAR; DR.D.THANGAMANI; DR.R.VEESAR VIGNESH; DR.N.JEYACHANDRAN

Volume : VIII, Issue : II, February - 2019

STUDY ON COMPARISON BETWEEN ORAL PARACETAMOL AND TRANSDERMAL FENTANYL FOR POSTOPERATIVE PAIN RELIEF IN PATIENTS UNDERGOING ELECTIVE DAYCARE SURGERY FOR INGUINAL HERNIA IN KAPV MEDICAL COLLEGE,TRICHY

Dr. Sri Hari, Dr. John Amalan, Dr. D. Sivakumar, Dr. D. Thangamani, Dr. R. Veesar Vignesh, Dr. N. Jeyachandran

Abstract :

INTRODUCTION: Postoperative pain is one of the main concerns for the patient undergoing surgery for inguinal hernia under spinal anaesthesia . Various techniques and drugs have been used for post operative pain relief with variable success.transdermal patches are now widely used as cosmetic, topical and transdermal delivery systems. Opioid are one of the most commonly used analgesics for postoperative pain and their transdermal patches provide sustained blood levels of the drug for sufficient period.in this study We compared fentanyl transdermal patch and oral paracetamol for postoperative pain relief in patients underwent surgery for inguinal hernia. Materials and Methods: It was a prospective comparative study involving 100 adult patients undergoing surgery for inguinal hernia under spinal anaesthesia.Group A: This group received oral paracetamol 500mg TDS.Group B: This group received Fentanyl patch of (12.5 �g/h), on hairless area of chest, back, flank and upper arm.Drug patches were applied to patients 6 hours before proposed surgery in both groups after noting baseline haemodynamic parameters.analgesia was assessed using visual analogue score for the next 2 days 12 hourly. Haemodynamic parameters and any adverse effects were also noted. Inj diclofenac (75 mg Im) was used as a rescue analgesic in patient complaining of inadequate pain relief. Results: The mean level of VAS was significantly lower in group B as compared to group A at Day 1, and day 2. The age of both the groups was almost similar and male/female ratio was also similar. Thus, both the groups were comparable in terms of age and sex. The systolic blood pressure (SBP), diastolic blood pressure (DBP), visual analogue scale (VAS) insignificantly different at Day 1. Haemodynamic variables in both groups (SBP, DBP and HR), shows comparable values in both groups and no significant difference was observed. Conclusion: we can conclude that both oral paracetamol and fentanyl TDS were effective in controlling postsurgical pain.fentanyl TDS has better analgesia. we recommend both oral paracetamol and fentanyl TDS for postoperative analgesia.but oral paracetamol is more cost effective and very few side effects, it should be preferred. However, if greater analgesia is required then fentanyl TDS is better.