Transdermal fentanyl versus intra venous morphine in postthoracotomy pain management

Transdermal fentanyl can be used for treatment of chronic pain and postoperative pain. The aim of this study was to compare the effect of transdermal fentanyl with that of IV morphine on post thoracotomy pain and their complications. 40 patients ASA I, II who had been selected randomly for thoracotomy, was divided into two similar groups. After operation, morphine 0.1mg/kg was administered IV Q6h for morphine group in ICU and in fentanyl group fentanyl patch 50 μg/h was administered 2 hours before operation. Also in both groups morphine 0.1mg/kg was infused PRN. SPSS13 was used for data analysis & P<0.05 was considered significant. Demographic parameters such as age, sex, weight and smoking were similar in two groups. Decrease of blood pressure was more in morphine group but it was not significant & increase of heart rate was more common in fentanyl group (p<0.01). Pain relief was more in fentanyl group (3.2 vs 4.6 score based on VAS). Morphine consumption in M group was three times more than that of fentanyl group (71±3.16 vs 22.5±9.79). Transdermal fentanyl was more effective than IV morphine for controlling post thoracotomy pain and respiratory changes were similar in both groups. Hypotension in morphine group was more common than that of fentanyl group but tachycardia was more prevalent in fentanyl group.