title: Efficacy and safety of transdermal fentanyl in the control of postoperative pain after photorefractive keratectomy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of transdermal fentanyl (TDF) in the control of postoperative pain following photorefractive keratectomy (PRK).
  
  
  METHODS
  One hundred ninety-nine consecutive PRK cases (398 eyes) were retrospectively reviewed. For postoperative pain control, 96 patients (63 females) were treated with tramadol 37.5 mg/acetaminophen 325 mg combination tablets (2 tablets bid), 103 patients (73 females) were treated with TDF (12 μg/h). Postoperative pain intensity using the visual analog scale (VAS) during postoperative 3 days including the evening of the day of the operation and peak pain intensity, rated using the verbal descriptor scale (VDS) at postoperative 4 days, were compared between 2 groups. Overall adverse events in the 2 treatment groups were also compared.
  
  
  RESULTS
  The differences in mean pain intensity scores were significant between the control group and the fentanyl group (P=0.001, Repeated-measures analysis of variance). The proportion of severe pain (VAS>54 mm) was significantly lower in the fentanyl group than the control group by morning of postoperative 2 days (P<0.007). The proportion of patients who rated their peak pain intensity as "intolerable pain" was significantly higher (P=0.001) in the control group (30/96, 31.3%) than the fentanyl group (13/103, 12.6%). Total number of patients who reported adverse events was significantly higher in the fentanyl group (P=0.013) than the control group. However, there were no irreversible or severe adverse events in both treatment groups and nausea was the most common (14/103, 13.6%) complaint reported in the fentanyl group.
  
  
  CONCLUSIONS
  TDF was more effective in the control of postoperative pain after PRK than tramadol/acetaminophen and no irreversible or severe adverse effect was reported with 12 μg/h concentration. TDF could be considered as alternative regimen of analgesic method after PRK.
authors.affiliation: Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea.
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Lee
authors.forename: Yang Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Joon Mo
authors.initials: JM
authors.lastname: Kim
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Bae
authors.forename: Chul Young
authors.initials: CY
authors.lastname: Choi
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000279:Administration, Cutaneous; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D018903:Photorefractive Keratectomy / Q000379:methods*; D012189:Retrospective Studies; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D057968:Transdermal Patch; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D009294:Narcotics; D000082:Acetaminophen; D014147:Tramadol; D005283:Fentanyl