Objective: To study the efficacy of transdermal nicotine patches (TNP) in postoperative somatic pain relief by assessing numerical rating scale (NRS) scores and opioid consumption.

Material and Method: A prospective, double-blind, placebo-controlled study was conducted in 46 patients, who received general anesthesia for elective arthroscopic shoulder surgery. All participants were randomly allocated to receive a patch of 7 mg nicotine or placebo before induction of anesthesia and remaining for 24 hours after surgery. Participants and assessors were blinded to allocation. Average pain score and intravenous morphine patient-controlled analgesia (PCA) consumption were assessed at 1 hour and 24 hours postoperatively.

Results: There was no significant difference in mean NRS and average opioid consumption at 1 hour and 24 hours postoperatively between controlled and treatment group. However, the significant reduction in average NRS from baseline at 1 hour and 24 hours postoperatively were found in both groups (p<0.001).

Conclusion: Administration of a 7 mg TNP did not significantly reduce in pain scores and postoperative opioid consumption compared with transdermal placebo during perioperative elective arthroscopic shoulder surgery.

Keywords: Transdermal nicotine patch, Postoperative pain control, Multimodal analgesia, Arthroscopic shoulder surgery