Comparison of the Efficacy of Transdermal Buprenorphine Versus Ketoprofen Patches for Post-operative Analgesia in Total Knee Arthroplasty: A Randomised Controlled Trial

Tushar Nayak; Mukund Madhav Ojha; Mohd Akhtar Ansari; Sandeep Sehrawat; Vivek Shankar; Shailendra Kumar; Vijay Kumar

doi:10.7759/cureus.72382

Comparison of the Efficacy of Transdermal Buprenorphine Versus Ketoprofen Patches for Post-operative Analgesia in Total Knee Arthroplasty: A Randomised Controlled Trial

Cureus. 2024 Oct 25;16(10):e72382. doi: 10.7759/cureus.72382. eCollection 2024 Oct.

Authors

Tushar Nayak¹, Mukund Madhav Ojha^{2

1}, Mohd Akhtar Ansari¹, Sandeep Sehrawat¹, Vivek Shankar¹, Shailendra Kumar³, Vijay Kumar¹

Affiliations

¹ Orthopaedics, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
² Orthopaedics, All India Institute of Medical Sciences, Bathinda, Bathinda, IND.
³ Anaesthesiology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.

Abstract

Introduction The utilisation of transdermal patches containing buprenorphine (BTP) and ketoprofen (KTP) has been widely documented for post-operative pain management. However, to date, no single study has comprehensively evaluated the efficacy of KTP and BTP specifically in managing post-operative pain following arthroplasty procedures. Methods A total of 100 consecutive patients undergoing primary total knee replacement between August 2022 and January 2023 were randomly assigned into two groups (Group KTP and BTP) using computer-generated numbers. Patients in Group BTP received a buprenorphine patch (10 µg/h) 24 hours before surgery, replaced on the seventh day and sustained for 14 days. Group KTP received a ketoprofen patch (20 mg) on the day of surgery, replaced daily for 14 days. Pain intensity was assessed using the Visual Analog Scale (VAS) score pre-operatively and post-operatively. Clinical outcomes included VAS scores at baseline, on post-operative days (POD) 2, 5, and 14, both at rest and during activity, need for rescue analgesia, adverse events, duration of hospital stay, post-operative range of motion (ROM), and patient satisfaction. Results Results revealed significantly lower VAS scores at rest in the BTP group for the initial five days, with similar trends observed for VAS scores during activity. No significant differences were found in VAS scores at day 14. There was an increased need for rescue analgesia in the KTP group compared to the BTP group. Post-operative ROM was consistently higher in the BTP group, although not statistically significant. Patient satisfaction scores favoured the BTP group throughout admission, with no remarkable adverse effects in either group. Conclusion In conclusion, BTP patches demonstrated enhanced efficacy in managing post-operative pain compared to KTP, without exacerbating side effects in the early stages following total knee arthroplasty. BTP can be definitively considered as an adjuvant in post-operative total knee arthroplasty analgesia.

Keywords: buprenorphine; ketoprofen; knee arthroplasty; postoperative pain; transdermal patch.