Comparison of the analgesic effects of transdermal fentanyl and intravenous patient controlled fentanyl after laparotomy

Aim: In our study, we aimed to show whether TDF patch application is effective and acceptable in the management of postoperative pain management. Material and Methods: In this prospective randomized study, 60 patients, aged between 18-65 years, who had undergone laparotomy, were included in the American Society of Anesthesiologists (ASA) I -II -III, after Gaziantep University local ethics committee approval. No patient was given premedication. The patients were randomly divided into two groups. TDF patch (50 mu g/hour) was applied to group TDF (n=30) 12 hours before the operation and removed 24 hours after the operation. Group patient -controlled intravenous fentanyl analgesia (PCA) (n=30) was administered postoperatively in the PACU with patientcontrolled analgesia with Intravenous fentanyl. When group TDF had pain (VAS 4 >=), 100 mg of tramadol was administered as an additional analgesic. Group TDF and Group PCA were clinically observed in the perioperative period. Results: Resting VAS was statistically significantly better in Group PCA than Group TDF at the 2nd, 4th, 6th, 12th, and 24th hours except the postoperative 1st hour (p<0.05). Additional analgesic requirement was statistically higher in group TDF than group PCA at 1st, 2nd, 6th, 12th, and 24th hours except postoperative 4th hour (p<0.05). Discussion: It has been concluded that IV fentanyl and PCA are more effective than TDF in the evaluation of patients in the postoperative period in terms of VAS scores, but TDF can be used as an alternative to patient -controlled analgesia for postoperative analgesia with tramadol support if necessary.