Özet:

We aimed to evaluate the use of transdermal fentanyl for postoperative pain. The study group consisted of 45 ASA I-II class patients undergoing oncologic gynecologic surgery. Patients were randomized to one of the three treatment groups. Group I received plasebo patch, group II received a patch delivering fentanyl 25 μg-h-1 and group III received a patch releasing fentanyl 50 μg-h-1 . Approximately 1 h after patch application, all patients were administered general anesthesia. After surgery, analgesia was provided with intravenous 1.5mg.kg-1 tramadol then analgesia continued via PCA device. All patients were assessed 4,12, 24, 32, 40, 48, 72 h after patch application and at the 12th h after patch removal. Measurements included respiratory rate, hemoglobin oxygen saturation by pulse oximetry and sedation. Pain intensity was measured with a 10-cm visual analogue scale (VAS). The tramadol dosage was recorded for 0-12, 12-20, 20-24, 24-32, 32-40, 40-48, 48-72 hour intervals. Upon completion of the protocol, patients and investigators each rated the analgesia. Compared to the plasebo group, there were significant differences at group II with respect to VAS pain scores at ambulation at 4, 12, 24. hours and at group III at 4, 12,24, 32, 40, 48. hours. Compared to plasebo, there were significant differences with respect to VAS pain scores at rest at 12. hour at group II and at 4, 12, 24, 32, 40, 48. hours at III. Tramadol requirement was lowest in group III. Patients' and investigators' satisfaction was good in group III compared with group I. We concluded that TTS fentanyl 50 μg-h-1 is better than TTS fentanyl 25 μg-h-1 for acute postoperative pain. If properly used, TTS fentanyl 50 μg-h-1 decreases the ambulation VAS pain score and decreases analgesic requirement with acceptable side effects

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