Efficacy of Fentanyl Transdermal Patch in Impacted Mandibular Third Molar Surgery-A Comparative Study

Removal of mandibular third molars surgically is one of the most frequently performed oral surgical procedures which are often accompanied with post-operative pain, swelling and trismus. Despite general progress in pain management, moderate to severe acute post-operative pain after removal of lower third molars remains a problem. Fentanyl is an extremely effective drug in the treatment of severe chronic pain such as cancer pain and post-operative pains which acts by increasing patient's tolerance to pain. Fentanyl Transdermal System (FTS) is a rectangular transdermal patch which contains high concentration of fentanyl, a potent short-acting Schedule II opiate. In this study the efficacy of transdermal fentanyl for management of post-operative pain after impacted mandibular 3rd molar surgery is evaluated.

20 patients within the age group of 18-40 years with asymptomatic impacted mandibular third molars were equally divided into 2 groups as group A & group B which underwent surgery in Local Anaesthesia. In every patient one side belonged to group A and other side belonged to group B. 50 μg FTS was applied in group A while placebo patch was applied in group B.

Patients in group A performed significantly better than group B in terms of mean pain intensity scores assessed by VAS and VRS along with minimum need of post-operative rescue analgesics.

It was found that FTS resulted in significantly better pain relief, longer pain-free intervals, and lesser post-operative analgesic consumption.