An evaluation of transdermal buprenorphine and transdermal fentanyl patch on quality of recovery-15 and analgesic effect following inguinal hernia surgery: a randomized controlled study

Background: Effective postoperative analgesia is essential for optimizing recovery and patient satisfaction after inguinal hernia surgery. Therefore, we compared transdermal buprenorphine and fentanyl patches with conventional analgesia for pain control and quality of recovery-15 (QoR-15).Methods: In this prospective, randomized study 150 patients classified as American Society of Anesthesiologists (ASA) I-III scheduled for elective open inguinal hernia repair were randomized into three groups; (n=50 each) Group B (buprenorphine 10 μg/h patch), Group F (fentanyl 25 μg/h patch), and Group C (intravenous paracetamol and tramadol). Patches were applied 12 h preoperatively. The primary outcome was visual analog scale (VAS) pain score, assessed at 1, 6, 12, and 24 h. Secondary outcomes included QoR‑15 scores and rescue‑analgesic requirements. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction.Results: Baseline demographic characteristics and perioperative hemodynamic parameters were comparable across groups. Median postoperative VAS scores at 6, 12, and 24 h were significantly lower in both transdermal groups than in the control group. QoR-15 scores at 24 h were 124 (122-125) (C), 127 (125-129) (F), and 133 (131-134) (B), at 48 h were 129 (128-130), 136 (134-138), and 137 (135-139) for Groups C, F, and B, respectively (P = 0.001).Conclusions: Transdermal buprenorphine and fentanyl provided effective postoperative analgesia and were associated with improved quality of recovery compared with standard analgesia. Buprenorphine showed a significant advantage over fentanyl in QoR-15 at 24 h, however, this difference was not significant at 48 h.