Study of Transdermal Buprenorphine Patch versus Oral Etoricoxib for Postoperative Pain Management after Total Knee Arthroplasty: A Randomized Comparative Open-label Study

Total knee arthroplasty (TKA) is a widely performed procedure for end-stage knee osteoarthritis, providing significant pain relief, improved joint function, and better quality of life. However, it is associated with substantial postoperative pain, which may delay mobilization, impair rehabilitation, prolong hospital stay, and increase the risk of chronic postoperative pain, thus making effective perioperative analgesia crucial for achieving optimal postoperative outcomes. This study aims to evaluate the efficacy and tolerability of transdermal buprenorphine patch versus oral etoricoxib for postoperative pain management in patients undergoing TKA, using Visual Analogue Scale (VAS) scores at rest and during movement for up to 1 week.

This randomized comparative study enrolled 88 patients of American Society of Anesthesiologists grade I/II after ethical approval. The patients were randomly allocated into two groups of 44 patients each. In Group A, patients received oral etoricoxib (90 mg), 1 h before surgery with a sip of water, and in Group B, patients received a transdermal buprenorphine patch (10 µg/h), 12 h before surgery. For statistical analysis, the Chi-square test and Student's t-test were used.

Statistically significant differences were observed in VAS scores (at rest and during movement), with Group B demonstrating significantly lower pain. Furthermore, rescue analgesic requirements and length of hospital stay were reduced significantly in Group B, thus indicating overall superior postoperative pain control.

Transdermal buprenorphine patch offers sustained analgesia (reduced VAS scores) with the potential for fewer systemic side effects, reduced need for additional opioid and rescue analgesic requirements, leading to shorter length of hospital stay.