Preemptive Use of the Nicotine Patch for Postoperative Pain Relief After Open Abdominal Surgery

Study patients include nonsmokers aged 18-75 undergoing open abdominal wall surgery under
general anesthesia. If the patient smokes, receives a regional anesthetic such as an
epidural, or is pregnant, then he/she is excluded from the study. There are two randomized
study groups. Group B receives a seven-milligram transdermal patch and Group A receives a
placebo patch. Generic seven-milligram nicotine patches or identical placebo patches made
from band-aids are glued to a 3x4 inch adhesive pad and placed on the individuals' right
upper arm 1 hour before surgery. All patients are given a standardized anesthetic consisting
of a narcotic infusion, propofol, a neuromuscular blocking agent, anesthetic gas agent,
antinauseant medication and a nonsteroidal.

Patients receive postoperative analgesia for twenty four hours after surgery with a narcotic
or an additional nonsteroidal medication. All patients receive intravenous controlled
patient controlled analgesia (IVPCA) with morphine sulfate one milligram per ten minutes,
forty milligram four hour limit. Patients also receive toradol fifteen milligrams for
breakthrough pain. The patch is removed from participants twenty four hours post IVPCA
initiation. The following items are assessed every four hours for twenty four hours after
post anesthesia care unit discharge: a verbal rating of pain, total IVPCA morphine use,
nausea occurrence, vomiting occurrence, and sedation score by the nurse.

Inclusion Criteria:

- Study patients include nonsmokers aged 18-75 undergoing open abdominal wall surgery
under general anesthesia.

Exclusion Criteria:

- If the patient smokes, receives a regional anesthetic such as an epidural, or is
pregnant, then he/she is excluded from the study.