Pre-emptive Diclofenac Versus Ketoprofen as a Transdermal Drug Delivery System: How They Face
To compare the analgesic efficacy of Diclofenac vis-a-vis Ketoprofen transdermal patch, in the management of immediate post-operative pain following orthognathic procedures.
Material and Method
A prospective, double-blinded, randomised controlled study was conducted among 50 subjects, between 2012 and 2015. These patients were diagnosed clinically and cephalometrically as skeletal and dental class II malocclusion and underwent bi-jaw surgical procedure. In total, 25 Diclofenac and 25 Ketoprofen transdermal patches, sealed in envelopes and numbered, were administered to subjects. The patches used, contained 100 mg of either Diclofenac or Ketoprofen and administered by a nurse prior to induction. Duration of analgesia, severity of pain using Visual Analog Scale, necessity of rescue analgesia (spontaneous pain > 5 on a 10-cm scale) and any other adverse effect associated with the drug were evaluated.
Mean duration of analgesia was significantly higher in the Ketoprofen group (20 h), compared to Diclofenac group (13 h) (p = 0.001). Rescue analgesia was required in 12% of subjects who received Diclofenac patch, compared to 4% in Ketoprofen group. None of the subjects showed any allergic reactions.
The study was designed to evaluate the efficacy of transdermal patch in reduction of post-operative pain in subjects undergoing bi-jaw surgeries. Subjects in both groups were comfortable and returned to early function. However, Ketoprofen transdermal patch had an edge over the Diclofenac transdermal patch with respect to analgesic efficacy.
KeywordsTransdermal patch Bi-jaw surgery Immediate post-operative pain Duration of analgesia
The authors would like to thank Dr. Anisha and Dr. Sasank for their general support and assistance.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 1.Ng P, Kam CW, Yau HH (2001) A comparison of Ketoprofen and Diclofenac for acute musculoskeletal pain relief: a prospective randomised clinical trial. Hong Kong. J Emerg Med 8:73–77Google Scholar
- 2.Dhiman S, Gurjeet TS, Rehni AK (2011) Transdermal patch: a recent approach to the new drug delivery system. Int J Pharm Pharm Sci 3(5):26–34Google Scholar
- 3.Kumar SV, Tarun P, Kumar TA (2013) Transdermal drug delivery system for non-steroidal anti-inflammatory drugs: a review indo American. J Pharm Res 3(5):3588–3605Google Scholar
- 4.Prausnitz MR, Mitragotri S, Langer R (2004) Current status and future potential of transdermal drug delivery. Nat Rev 3:115–124Google Scholar
- 7.Prabhakar H, Shrirao SA, Shelgaonkar VC, Ghosh AA (2005) Comparative evaluation of intramuscular Ketoprofen and Diclofenac sodium for postoperative pain relief. Internet J Anesthesiol 11:1Google Scholar
- 9.Atzeni F, SarziPuttini P, Lanata L, Bagnasco M (2013) Efficacy of Ketoprofen vs ibuprofen and Diclofenac: a systematic review of the literature and meta analysis. Arthritis Rheum 31(5):731–738Google Scholar
- 10.Krishna R, Nataraj MS (2012) Efficacy of a single dose of a transdermal Diclofenac patch as pre-emptive postoperative analgesia: a comparison with intramuscular Diclofenac. S Afr J Anaesth Analg 18(4):194–197Google Scholar
- 14.Tanida N, Sakurada S (2008) Skin permeability, anti-inflammatory and analgesic effects of Ketoprofen-containing tape and loxoprofen sodium containing tape. Jpn Pharmacol Ther 36:1123–1129Google Scholar