Postoperative analgesia and plasma levels after transdermal fentanyl for orthopedic surgery: Double-blind comparison with placebo

Bastelaere, Martine Van; Rolly, G; Abdullah, Nurshariza

doi:10.1016/0952-8180(94)00000-t

Cited by 21 publications

(7 citation statements)

References 6 publications

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“…[3] In another study in 1995, fentanyl concentration showed a wide range (0.85–2.95 ng/mL) and respiratory problems developed in 1 patient whose concentration of fentanyl was 1.79 ng/mL. [6]…”

Section: Discussionmentioning

confidence: 99%

Is the transdermal fentanyl patch an efficient way to achieve acute postoperative pain control?

et al. 2018

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Backgroupd:This study investigated the plasma fentanyl concentration and efficacy of transdermal fentanyl patch (TFP) (25 μg/h) in the management of acute postoperative pain.Methods:Patients undergoing laparoscopic cholecystectomy were randomly allocated to 2 groups. The TFP group (n = 30) received a single TFP 25 μg/ h to the anterior chest wall 14 h before operation. The IV group (n = 30) received a placebo patch. After the operation, intravenous fentanyl infusion (25 μg/h) was begun with loading dose 25 μg in the IV group and only normal saline in the TFP group. Plasma fentanyl levels were measured at admission, 1, 6, 12, 24, and 48 h postoperatively. Pain severity and adverse effects were evaluated too.Results:The fentanyl level peaked 1 h after operation in the TFP group (3.27 ± 0.34 ng/mL) and 24 h postoperatively in the IV group (2.9 ± 0.42 ng/mL). Pain scores and the use of rescue analgesics were not significantly different between 2 groups. Respiratory depression was not happened in both groups.Conclusions:The TFP (25 μg/h) affixed 14 h before surgery reached a higher constant concentration than the same dose setting of a constant IV infusion of fentanyl after surgery. Although the concentration of fentanyl was higher than those of previous researches, there was no respiratory depression. But, there was no advantage of reducing pain score and the use of rescue analgesics. Clinical trial registration: (available at: http://cris.nih.go.kr, KCT0002221).

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Section: Discussionmentioning

confidence: 99%

Is the transdermal fentanyl patch an efficient way to achieve acute postoperative pain control?

et al. 2018

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“…In a review, Nelson and Schwaner concluded that close observation by well-trained personnel is needed, due to serious adverse effects from unintentional misuse or even in normal use 26. In cases of severe bradypnea, naloxone can be used to treat the symptoms promptly 27. Since the duration of TFPs is much longer than naloxone, one dose of naloxone may be insufficient, and a continuous infusion may be needed.…”

Section: Discussionmentioning

confidence: 99%

Transdermal fentanyl patch for postoperative analgesia in total knee arthroplasty: a randomized double-blind controlled trial

Sathitkarnmanee¹,

Tribuddharat²,

Noiphitak³

et al. 2014

JPR

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PurposeTo assess the efficacy of a transdermal fentanyl patch (TFP) (50 μg/hour) applied 10–12 hours before surgery versus placebo for postoperative pain control of total knee arthroplasty (TKA).Materials and methodsWe enrolled 40 patients undergoing elective TKA under spinal anesthesia using isobaric or hyperbaric bupivacaine. Subjects were randomized to receive a TFP (Duragesic® 50 μg/hour) or placebo patch applied with a self-adhesive to the anterior chest wall 10–12 hours before spinal anesthesia. Every patient was given patient-controlled morphine for postoperative pain control. Patients were evaluated every 4 hours until 48 hours.ResultsMorphine consumption at 24 and 48 hours in the TFP group versus the placebo group was 15.40±12.65 and 24.90±20.11 mg versus 33.60±19.06 and 57.80±12.65 mg (P≤0.001). Numeric rating scale scores at rest and during movement over 48 hours were lower in the TFP group. Ambulation and nausea/vomiting scores were statistically greater, but not clinically significant in the TFP group. Sedation scores were low and not statistically significantly different between groups. There was no severe respiratory depression.ConclusionTFP (50 μg/hour) applied 10–12 hours before surgery can effectively and safely decrease morphine consumption and pain scores during the first 48 hours after TKA surgery.

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“…The transdermal administration of fentanyl in the peri‐anesthetic period has the potential to produce clinically significant respiratory depression as well as delayed recovery because of prolonged sedation (Downes et al. 1967; van Bastelaere et al. 1995).…”

Section: Discussionmentioning

confidence: 99%

The effect of inhalant anesthetic and body temperature on peri-anesthetic serum concentrations of transdermally administered fentanyl in dogs

Pettifer

Hosgood

2004

Veterinary Anaesthesia and Analgesia

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Postoperative analgesia and plasma levels after transdermal fentanyl for orthopedic surgery: Double-blind comparison with placebo

Cited by 21 publications

References 6 publications

Is the transdermal fentanyl patch an efficient way to achieve acute postoperative pain control?

Is the transdermal fentanyl patch an efficient way to achieve acute postoperative pain control?

Transdermal fentanyl patch for postoperative analgesia in total knee arthroplasty: a randomized double-blind controlled trial

The effect of inhalant anesthetic and body temperature on peri-anesthetic serum concentrations of transdermally administered fentanyl in dogs

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