Transdermal Ketoprofen Versus Fentanyl Patches for Pain Management Post-cesarean Section: A Comparative, Randomized, Double-Blind Study.

Autor:	Baheti S; Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND., Muruganantham S; Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Nov 13; Vol. 16 (11), pp. e73635. Date of Electronic Publication: 2024 Nov 13 (Print Publication: 2024).
DOI:	10.7759/cureus.73635
Abstrakt:	Introduction: Postoperative pain management after a cesarean section is essential to promote mother-infant bonding and ease of breastfeeding. Transdermal patches present a viable alternative to oral medications, offering controlled drug delivery and better bioavailability while avoiding first-pass metabolism, all of which can facilitate smoother recovery and rehabilitation. Methods: This comparative, randomized, double-blind study was conducted on 70 parturients scheduled for cesarean section under spinal anesthesia, classified as ASA II. Patients were randomly divided into two groups: Group K (transdermal ketoprofen patch, 30 mg) and Group F (transdermal fentanyl patch, 25 mcg). The patches were applied immediately after spinal anesthesia. Pain was assessed using the Visual Analogue Scale (VAS), and sedation was assessed using the Richmond Agitation-Sedation Scale for 24 hours. Results: There was no statistically significant difference in the VAS scores between the two groups from two to 14 hours postoperatively. However, a statistically significant difference was observed at 16 hours (Group K 2 ± 0.87 vs. Group F 2.5 ± 0.86, p = 0.029) and 20 hours (Group K 1.77 ± 0.86 vs. Group F 2.33 ± 0.8, p = 0.011). Rescue analgesia was required in seven (20%) of the patients in Group K and 12 (34.29%) of the patients in Group F, though this difference was not statistically significant. At 20 hours, Group K had more alert and calm patients (33 (94.29%) vs. 26 (74.29%)), with fewer drowsy or restless patients compared to Group F (p = 0.044). At 24 hours, Group K had significantly fewer drowsy patients (0 (0%) vs. 13 (37.14%)) and more alert patients (34 (97.14%) vs. 19 (54.29%)), with fewer restless patients (p < 0.0001). Conclusion: Both the ketoprofen patch (30 mg) and the fentanyl patch (25 mcg) provided comparable analgesia for the first 12 hours. However, at 16 and 20 hours, the ketoprofen patch was more effective than the fentanyl patch in providing analgesia. More patients in the fentanyl group were drowsy after 16 hours, though normal sleep patterns may have contributed to this observation. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Dr. D. Y. Patil Medical Hospital and Research Center Institutional Ethics Committee issued approval IESC/FP/59/2023. The study is approved for research. CTRI number: CTRI/2024/02/062335. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Baheti et al.)
Databáze:	MEDLINE
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