Comparative Efficacy of Buprenorphine Transdermal Patch Versus Tramadol in Postoperative Analgesia for Shoulder Arthroscopy: a Prospective, Randomized Controlled Trial.

Background: Shoulder arthroscopy is a regular surgery that usually results in a lot of post operative pain. Pain management is important in order to maximize both recovery and rehabilitation. Commonly applied are traditional analgesics (tramadol) but opioid analgesics can offer better pain relief with fewer side effects like buprenorphine. Aim: The hypothesis of the research study is that buprenorphine transdermal patches (TDBP) would be more effective in managing pain and have less adverse events than oral tramadol after shoulder arthroscopy. Methods: It was a prospective, randomized, controlled trial involving 70 patients who underwent shoulder arthroscopy and who were randomly assigned to either using buprenorphine (Group P) or tramadol (Group T). The main effects were the levels of pain at different time intervals (6, 12, 24, 48, and 72 hours), and the secondary ones were the level of patient satisfaction, occurrence of adverse effects, effective analgesia time, and effective use of analgesics. Results: Buprenorphine patients were found to rate pain as significantly low at 12 hours (2.57 vs. 3.11), 18 hours (3.11 vs. 4.03), and 72 hours (2.11 vs. 2.63). Patient satisfaction was significantly greater in the buprenorphine group (4.43 ± 0.56 vs. 3.40 ± 1.19, p = 0.01). The buprenorphine group had much less adverse effects such as nausea and vomiting. The effective analgesia time was greater in the buprenorphine group (18.60 ± 3.13 hours vs. 15.14 ± 2.02 hours, p = 0.03). Moreover, fewer rescue analgesics were used by the buprenorphine group (10.35 ± 3.45 mg vs. 18.12 ± 4.22 mg, p = 0.04). Conclusion: Buprenorphine transdermal patches are effective in pain relief, more patient-satisfied, and have less side effects than oral tramadol in the postoperative treatment of shoulder arthroscopy, which makes it a promising option in postoperative analgesia.