Comparative Study between Transdermal Buprenorphine Patch with Intravenous Tramadol for Post-operative Analgesia in Laparotomy Cases

Post-operative pain is very common in laparotomy cases. It is one of the main concerns for the patient undergoing major surgery. Various techniques and drugs have been used for this purpose with variable success. Every technique and drugs has its own advantages and disadvantages. The present study compares transdermal buprenorphine patch and intra venous tramadol in relieving post-operative pain. Sixty patients aged 18 to 60 years scheduled for laparotomy under general anaesthesia in Poona Hospital and Research Centre, Pune between May 2014 and November 2015 were included in this prospective, randomised double-blind study. They were randomly divided into two groups. Group B patients received transdermal buprenorphine patch of 10 mg six hours prior to surgery whereas Group T patients received intravenous tramadol 1 mg per kg half hour prior to completion of surgery. Comparison of quantitative variables between the groups was done using unpaired student's “t” test, whereas comparison of qualitative variables was done by using chi-square test or Fisher's exact test. Visual analogue scale pain score at 0 hr, 8 hrs, 10 hrs, 12 hours and 24 hrs was significantly higher in tramadol group compared to buprenorphine group. Incidence of post-operative nausea and vomiting was significantly higher in tramadol group compared to buprenorphine group. Majority of patients in buprenorphine group required rescue analgesia up to 6 hrs and in tramadol group, majority of patients required rescue analgesia after six hours which was statistically significant. Buprenorphine is more effective than tramadol for post-operative analgesia in laparotomy cases.