• M van Bastelaere, G Rolly, and N M Abdullah.
• Department of Anesthesiology, University Hospital, Ghent, Belgium.
• J Clin Anesth. 1995 Feb 1; 7 (1): 26-30.

Study ObjectiveTo determine whether transdermal fentanyl can provide a significant component of postoperative analgesia.DesignRandomized, double-blind study.SettingInpatient surgery in a university hospital.Patients40 adult patients scheduled for orthopedic surgery with general anesthesia.Interventions20 patients in each group had general anesthesia with propofol, isoflurane in nitrous oxide and oxygen (O2), and small boli of alfentanil or sufentanil. Preoperatively, the first group (F) received a transdermal therapeutic system fentanyl patch (75 micrograms/hr) for 72 hours, and the second group (P) received a placebo patch. Morphine was given postoperatively according to clinical necessity.Measurements And Main ResultsMorphine consumption, pain visual analog scale, and eventual sedation were assessed, as well as respiratory rate and blood pressure. Plasma fentanyl concentrations were determined. Only 11 Group F patients needed morphine compared with 19 Group P patients, and mean morphine dose was significantly lower in Group F. One Group F patient had decreased O2 saturation and intense sedation, necessitating administration of naloxone. The mean maximum plasma fentanyl concentration in Group F was 1.63 ng/ml.ConclusionEfficacy of transdermal fentanyl for postoperative pain relief is shown, but intense respiratory depression is sometimes seen.

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