Clinical Research on Transdermal Fentanyl Used for Postoperative Acute Pain Management

Objective:To research the feasibility,efficacy and method of transdermal fentanyl patch(TDF) in the treatment of postoperative pain.Methods:60 women were divided into 3 groups.All patients received TDF 5?mg.Group T and TM received abdominal hysterectomy and epidural anesthesia.Group TM received morphine 1.5～2?mg besides.Group TG received breast cancer resection and general anesthesia.The changes of plasma β-endorphin,serum prolactin and cortisol before and after patch application were analyzed.Heart rate,respiratory rate,SpO_2,blood pressure,pain score(VAS),and adverse reactions were monitored at prescribed intervals.Results:VAS pain score was higher in group T at first 24?h after patch application,and gradually down at 24 h after patch application.The analgesia effect was better in group TM than in group T,but more respiratory depression may occur.Group TG and TM had similar analgesia.The concentrations of stress hormone were significantly higher in group T at 24?h after patch application.There was no significant difference in the incidence of adverse effects in all 3 groups.Conclusion:Breast cancer resection can apply TDF 5?mg for postoperative analgesia alone.The analgesia effect was good and safe. If TDF 5 mg is used for hysterectomy postoperative analgesia,the patients need to be assisted by other analgesics until plasma fentanyl concentration reaches a peak level,thereby the analgesia effect can be better.