Efficacy Comparison of Transdermal Fentanyl and IV Morphine PCA in Post-orthopedic Surgery Pain: A Randomized Clinical Trial

Authors : Seher İlhan, Habib Atalay
Pages : 441-449
Doi:10.37990/medr.1634371
View : 60 | Download : 92
Publication Date : 2025-05-09
Article Type : Research Paper
Abstract :Aim: Effective postoperative pain management is crucial for early mobilization and recovery in orthopedic surgery patients. While intravenous patient-controlled analgesia (IV-PCA) with morphine is widely used, it has limitations including IV access dependency and mobility restrictions. Transdermal fentanyl (TDF) patches have emerged as an alternative due to their long-lasting analgesic effects. This study compares their efficacies in managing postoperative pain following orthopedic surgeries and evaluates patient satisfaction levels. Material and Method: This prospective, randomized, controlled, comparative study included 40 patients aged 20-65 years undergoing orthopedic surgery under general anesthesia between July-December 2010. Patients were randomized into Group TDF (n=20) and Group IV-PCA (n=20). Postoperative pain intensity quantification was performed utilizing standardized VAS methodology, while concurrent sedation depth monitoring employed RSS parameters throughout the initial 24-hour postoperative period. Additionally, hemodynamic parameters, rescue analgesia requirements, side effects, and satisfaction levels were monitored. Results: Post-surgical nociceptive metrics demonstrated significant temporal reduction across both cohorts (p .05). Patient-reported satisfaction metrics indicated significant preference for automated morphine administration protocols (p<.001). Conclusion: Despite providing adequate initial pain relief, TDF patches demonstrated lower efficacy compared to IV-PCA with morphine in managing postoperative pain and achieving patient satisfaction following orthopedic surgery. These findings suggest the need for careful consideration when selecting postoperative pain management strategies.
Keywords : Pain, postoperative, patient-controlled analgesia, fentanyl/therapeutic use

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