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丁丙诺啡透皮贴剂在口腔颌面外科术后疼痛管理中的疗效

Efficacy of Transdermal Buprenorphine Patch in Postoperative Pain Management in Oral and Maxillofacial Surgery.

作者信息

N Mythili, Navaneetham Romir, Sham M E, Menon Suresh, Kumar Veerendra, S Archana

机构信息

Department of Oral Maxillofacial Surgery, Vydehi Institute of Dental Sciences, #82 EPIP Zone, Near BTMC 18th Depot, Vijayanagar, Whitefield, Bangalore, 560066 India.

Bangalore, India.

出版信息

J Maxillofac Oral Surg. 2024 Oct;23(5):1234-1239. doi: 10.1007/s12663-022-01818-y. Epub 2022 Nov 11.

Abstract

AIM

To evaluate the therapeutic efficacy of transdermal Buprenorphine patch in postoperative pain management in Major Oral and Maxillofacial surgeries done under general anesthesia.

MATERIALS AND METHOD

A total number of 100 subjects, both males and females in the age group of 18-60 years were included in the study. At the screening visit, a brief medical history was recorded for each prospective subject. The subject was selected according to the inclusion and exclusion criteria and consent was taken before placing the patch. For a period of 7 days, 10 mg Buprenorphine patch was placed on the skin of the patient for 3 h before the surgery. Analgesic efficacy was recorded for the next 7 days by using visual analogue scale (hereinafter refered to as ""). If the VAS score was above 5, the rescue analgesia inj. Dynapar I.V was administered to the patient.

RESULTS

The mean VAS score in females 4.4, was high when compared to males 3.9, which would suggest that the patch was more effective in males compared to females. Trauma patients showed mean VAS score of 3.9 and pathology patients showed a mean VAS score of 4.1. 36% of the patients required additional analgesics as the VAS score was more than 5. 20% of patients between age group of 20-30 years required additional analgesics, 66.7% in 31-40yrs, 0% of 41-50yrs and 13.3% in 51-60yrs required additional analgesics. 24% of the females patients required 37 additional analgesics compared to the 12% in male patients. 21.6% of patients treated for pathology required additional analgesics compared to the 8.2% in trauma patients. Thus, the sensitivity of this study was 94.1% and specificity was 33.3%.

CONCLUSION

Buprenorphine has high analgesic potential, good safety profile, ease of opioids switches and reversibility by μ- antagonist. Transdermal route is cost effective and has increased patient compliance and ease of handling with less adverse effects. Thus, the efficacy of transdermal buprenorphine in postoperative pain management was good.

摘要

目的

评估透皮丁丙诺啡贴剂在全身麻醉下进行的口腔颌面大手术术后疼痛管理中的治疗效果。

材料与方法

本研究共纳入100名年龄在18 - 60岁之间的男性和女性受试者。在筛查访视时,为每位潜在受试者记录简要病史。根据纳入和排除标准选择受试者,并在贴敷贴片前获得同意。在手术前3小时,将10毫克丁丙诺啡贴剂贴于患者皮肤上7天。在接下来的7天内,使用视觉模拟评分法(以下简称“VAS”)记录镇痛效果。如果VAS评分高于5分,则给患者静脉注射地佐辛进行补救镇痛。

结果

女性的平均VAS评分为4.4分,高于男性的3.9分,这表明该贴片对男性的效果比对女性更有效。创伤患者的平均VAS评分为3.9分,病理患者的平均VAS评分为4.1分。36%的患者因VAS评分超过5分而需要额外的镇痛药。20 - 30岁年龄组的患者中有20%需要额外镇痛药,31 - 40岁年龄组中有66.7%,41 - 50岁年龄组中为0%,51 - 60岁年龄组中有13.3%需要额外镇痛药。24%的女性患者需要额外镇痛药,而男性患者为12%。接受病理治疗的患者中有21.6%需要额外镇痛药,而创伤患者为8.2%。因此,本研究的敏感性为94.1%,特异性为33.3%。

结论

丁丙诺啡具有高镇痛潜力、良好的安全性、易于进行阿片类药物转换以及可被μ拮抗剂逆转。透皮给药途径具有成本效益,提高了患者的依从性,易于操作且不良反应较少。因此,透皮丁丙诺啡在术后疼痛管理中的疗效良好。

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