Transdermal fentanyl patch improves post-operative pain relief and promotes early functional recovery in patients undergoing primary total knee arthroplasty: a prospective, randomised, controlled trial

Introduction

The aim of the present study was to evaluate the efficacy and safety of a 12.5 μg/h transdermal fentanyl patch (TFP).

Materials and Methods

Fifty-two patients scheduled for primary total knee arthroplasty (TKA) were recruited in the study. They were randomly divided into two groups: patients provided with a transdermal fentanyl patch (Group TFP) and those provided with non-steroid anti-inflammatory drugs (Group NSAID). The patients in the TFP and NSAID groups had mean ages of 70.1 years (range 36–86 years) and 73.5 years (range 32–86 years), respectively. Post-operative pain intensity was measured using the visual analogue scale both at rest and during movement (mVAS). We also evaluated lower leg functional recovery and adverse events.

Results

The mean mVAS scores were not different between the two groups on post-operative day 4, but were significantly smaller in the TFP group than in the NSAID group on post-operative days 7 (p = 0.0026) and 14 (p = 0.007). Muscle strength recovered faster in the TFP group than in the NSAID group, the percentage of pre-operative strength being significantly greater in the former than in the latter on post-operative days 7 (p = 0.027) and 14 (p = 0.047). Furthermore, there were no remarkable adverse events in patients using TFP.

Conclusion

We conclude that a 12.5 μg/h TFP can improve post-operative pain relief and promotes early functional recovery following total knee arthroplasty.