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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Neuropharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1412099

Transdermal buprenorphine patch as an adjunct to multimodal analgesia after total joint arthroplasty: a retrospective cohort study

Provisionally accepted
Xiaoli Fang Xiaoli Fang 1,2Yueping Zhao Yueping Zhao 3Yao Yao Yao Yao 4Jianghui Qin Jianghui Qin 4Yan Lin Yan Lin 5Jin Yang Jin Yang 6*Ruijuan Xu Ruijuan Xu 2,4*
  • 1 China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China
  • 2 Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
  • 3 School of Pharmacy, China Pharmaceutical University, Nanjing, China
  • 4 Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, Nanjing, China
  • 5 Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
  • 6 Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing, China

The final, formatted version of the article will be published soon.

    Background: Total hip arthroplasty or total knee arthroplasty (THA/TKA) is often associated with varying degrees of pain. In recent years, transdermal buprenorphine (TDB) patch has shown encouraging results for acute postoperative pain control in orthopedic surgery. The aim of our study was to investigate the efficacy and safety of the combination of TDB patch and nonsteroidal antiinflammatory drugs (NSAIDs) as a multimodal analgesic regimen after THA/TKA. Methods: Patients who underwent THA and TKA between January 2022 and January 2023 were reviewed. Three postoperative analgesic regimens were selected: Group A (flurbiprofen 50mg and tramadol 37.5 mg/acetaminophen 325 mg), Group B (flurbiprofen 50mg and TDB 5mg), and Group C (Parecoxib 40mg and TDB 5mg). The primary outcomes were the Wong-Baker face pain scale revision (FPS-R) scores and the rate of sleep disturbances. Secondary outcomes of the study included the proportion of patients with postoperative pain relief rates categorized as 0%, <50%, ≥50%, and 100%.Results: The dynamic FPS-R pain scores on day 3 after surgery in Group B were significantly lower than those in Group A for THA (P <0.017). The dynamic FPS-R pain scores were lowest in Group C on day 2 and 3 after THA and TKA (P <0.017). Rate of sleep disturbances was significantly lower in Group B for THA and in Group C for TKA, respectively, compared with that in Group A (P <0.017). The proportion of dynamic pain relief rate ≥50% in Group C was statistically higher than that in Group A for THA (P <0.017). Rate of adverse reactions among three groups for THA and TKA was not statistically different (P > 0.05).Conclusion: This study suggests that the combination of TDB patch and NSAIDs is safe and effective for postoperative analgesia after THA/TKA.

    Keywords: Transdermal buprenorphine patch, total joint arthroplasty, Analgesia, Postoperative pain, Multimodal analgesia

    Received: 04 Apr 2024; Accepted: 10 Sep 2024.

    Copyright: © 2024 Fang, Zhao, Yao, Qin, Lin, Yang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jin Yang, Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing, China
    Ruijuan Xu, Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.