BACKGROUND AND OBJECTIVE: Effective control of postoperative pain is very important to reduce its complications. This study was performed to compare the efficacy of trans-dermal fentanyl patch and intravenous morphine on postoperative pain of esophageal cancer surgery with trans-hiatal approach.

METHODS: In this double blind clinical trial study, 57 ASA class I-II patients who scheduled for elective esophageal cancer surgery with trans-hiatal approach were randomly divided into two groups (M=Morphine, F=Fentanyl patch). In a fentanyl group (F), a TFP (50 µg/h) was placed on chest wall skin one hour before the induction of anesthesia. In M group, morphine 4 mg was administrated at the end of surgery. Pain score, blood pressure, heart rate and respiratory rate in 0-2-4-6 and then every 6 hours for 72 hours after surgery were measured. In both groups 4mg intravenous morphine was administered to the patient if they had pain score (base of visual analogue scale) more than three. Finally, the mean amount of morphine, pain score, the incidence of respiratory depression, changes in blood pressure and heart rate in two groups was compared. (IRCT:201110107752N1)

FINDINGS: The numbers of patients in fentanyl and morphine groups were 29 and 28, respectively. The two groups were similar for age, gender and weight. The efficacy of TFP to reduce pain score after operation was better than the Morphine group (p<0.001). The mean amount of prescribed morphine in M group was (64±3.82mg) and in F group (20±5.63mg) (p<0.05). The incidence of respiratory depression, blood pressure and heart rate variation was not significant in two groups.

CONCLUSION: This study showed that the transdermal fentanyl patch (TFP) could be an appropriate and effective method to reduce postoperative pain of esophageal cancer surgery with trans-hiatal approach.