Patient-Controlled Intranasal Analgesia

Striebel, H. W.; Oelmann, Thomas; Spies, Claudia; Rieger, Armin; Schwagmeier, R.

doi:10.1097/00000539-199609000-00019

Cited by 19 publications

(1 citation statement)

References 8 publications

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“…Striebel et al compared these methods in 42 patients undergoing surgery for lumbar disc protrusion [23] and 50 patients undergoing orthopaedic surgery [24]. Several studies investigated fentanyl PCINA or PCIA.…”

Section: Post-operative Acute Pain Management -Adultsmentioning

confidence: 99%

The Clinical Applications of Intranasal Opioids

Shelley

Paech²

2008

CDD

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Opioids are widely used in all fields of pain management and may be delivered by a number of routes of administration. The intranasal administration of opioid is a convenient route of transmucosal drug delivery that has received limited attention. Potential advantages compared with parenteral or oral administration include avoidance of painful injection, avoidance of risks associated with intravenous access, rapid onset and titration to effect, good bioavailability, and high levels of acceptability and familiarity to patients. These features also lend themselves to the benefits of patient-controlled delivery systems and commercially available devices are described.In this paper we briefly consider the relevant pharmacology of intranasal drug delivery; opioid drugs and formulations; and delivery devices used clinically for intranasal administration. We review the clinical applications of intranasal opioid analgesia. These have included use for in-hospital pain management in adult and paediatric populations, in the emergency department, perioperatively and in burns units. Out-of-hospital use has included palliative care and paramedic use during retrieval and transfer to hospital. Many small trials suggest that intranasal opioids play a useful role in pain management, but large clinical trials are needed to better define advantages, safety and acceptability.

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Section: Post-operative Acute Pain Management -Adultsmentioning

confidence: 99%

The Clinical Applications of Intranasal Opioids

Shelley

Paech²

2008

CDD

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Opioids: overview on action, interaction and toxicity

Lehmann

1997

Support Care Cancer

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Fentanyl Formulations in the Management of Pain: An Update

Schug

Ting

2017

Drugs

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Fentanyl is a synthetic, highly selective opioid with many desirable physicochemical properties, including a high lipophilicity and predictable pharmacokinetics. These properties have an established record in the management of pain in a variety of settings, particularly acute pain and breakthrough cancer pain. Fentanyl was initially developed for parenteral use; however, this is invasive and impractical in the outpatient setting. Unfortunately, the high first-pass metabolism of fentanyl makes oral formulations unfeasible. However, its high lipophilicity allows fentanyl to be absorbed via a number of other routes. Thus new formulations were designed to allow non-invasive methods of administration. Transmucosal and transdermal fentanyl formulations are well established, and have proven useful in the settings of breakthrough cancer pain, emergencies and in the paediatric population. The iontophoretic transdermal system was developed to provide a needle-free system of delivering bolus doses of fentanyl on demand, a novel way of delivering patient-controlled opioid analgesia. Transpulmonary administration of fentanyl remains experimental. The aim of this review is to provide an update on current non-parenteral fentanyl formulations, with attention to their particular pharmacokinetics and features relevant to clinical use in pain management.

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Patient-Controlled Intranasal Analgesia

Cited by 19 publications

References 8 publications

The Clinical Applications of Intranasal Opioids

The Clinical Applications of Intranasal Opioids

Opioids: overview on action, interaction and toxicity

Fentanyl Formulations in the Management of Pain: An Update

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