Hosseini H, Kargar S, Shiryazdi S M, Kargar S, Rezaie F, Neamatzadeh H
Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran -
Minerva Chir. 2015 Dec;70(6):401-8. Epub 2014 Dec 17.
The fentanyl transdermal patch (Duro-gesic® D-TRANS) is a strong pain medication for moderate to severe chronic pain that can provide long-lasting relief for persistent pain. This study was conducted to determine the analgesia and adverse effects of the fentanyl transdermal patch (Durogesic® D-TRANS) postelective laparotomy.
One-hundred twenty patients undergoing elective laparotomy were randomized into two groups of fentanyl and placebo. In the first group, patients received two fentanyl patches with 25 and 50 µg in 10 hours preoperatively. Patient's postoperative assessments included pain score, adverse effects, mean amount and interval of supplementary morphine, respiratory rate and oxygen saturation, which were recorded during 36 hours.
The mean pain intensity scores over 36 hours in fentanyl transdermal patch durogesic (FTD) group were significantly less than placebo group (FTD, 35.28; placebo, 46.61 and P=0.01). However, the pain score at the 3rd timepoint in the placebo group was slightly less than the FTD group (39.4±2.23 vs. 39.47±4.97, respectively). The mean interval and amount of supplementary morphine were significantly better in the FTD group than the placebo group (FTD 367.7±349.7 min vs. placebo 59±13.88 min; P=0.04 and FTD 2.10±3.46 mg vs. 29.15±3.71 mg; P<0.001, respectively). The incidence of adverse effects including vomiting (FTD 16 vs. placebo 9; P=0.45), nausea (FTD 22 vs. placebo 18; P=0.33), itching (FTD 16 vs. placebo 18; P=1.00) and respiratory depression (FTD 1 vs. placebo 0; P=1.00) were not significant between the groups, except the dizziness that had a higher incidence in the FTD group (FTD 23 vs. placebo 1; P=0.02).
It seems that the fentanyl transdermal patch system is a safe and effective procedure to use in post laparotomy analgesia and its related adverse effects are not serious.
芬太尼透皮贴剂（多瑞吉®D - TRANS）是一种用于中度至重度慢性疼痛的强效止痛药物，可为持续性疼痛提供持久缓解。本研究旨在确定芬太尼透皮贴剂（多瑞吉®D - TRANS）在择期剖腹手术后的镇痛效果及不良反应。
120例行择期剖腹手术的患者被随机分为芬太尼组和安慰剂组。第一组患者在术前10小时接受两片分别含25μg和50μg的芬太尼贴剂。对患者术后的评估包括疼痛评分、不良反应、补充吗啡的平均用量和间隔时间、呼吸频率及血氧饱和度，这些指标在36小时内进行记录。
芬太尼透皮贴剂多瑞吉（FTD）组36小时内的平均疼痛强度评分显著低于安慰剂组（FTD组为35.28，安慰剂组为46.61，P = 0.01）。然而，安慰剂组在第3个时间点的疼痛评分略低于FTD组（分别为39.4±2.23和39.47±4.97）。FTD组补充吗啡的平均间隔时间和用量显著优于安慰剂组（FTD组为367.7±349.7分钟，安慰剂组为59±13.88分钟；P = 0.04；FTD组为2.10±3.46毫克，安慰剂组为29.15±3.71毫克；P < 0.001）。两组间不良反应的发生率，包括呕吐（FTD组16例，安慰剂组9例；P = 0.45）、恶心（FTD组22例，安慰剂组18例；P = 0.33）、瘙痒（FTD组16例，安慰剂组18例；P = 1.00）及呼吸抑制（FTD组1例，安慰剂组0例；P = 1.00），差异均无统计学意义，但FTD组头晕的发生率较高（FTD组23例，安慰剂组1例；P = 0.02）。
芬太尼透皮贴剂系统似乎是一种用于剖腹手术后镇痛的安全有效的方法，且其相关不良反应并不严重。
