Reduced morphine consumption and pain severity with transdermal fentanyl patches following total knee arthroplasty

Abrisham, Seyed Mohammad Jalil; Ghahramani, Rahil; Heiranizadeh, Najmeh; Kermani-Alghoraishi, Mohammad; Ayatollahi, Vida; Pahlavanhosseini, Hamid

doi:10.1007/s00167-012-2287-9

Cited by 14 publications

(6 citation statements)

References 25 publications

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“…The KFD combination provides a stable anesthesia and alleviates the tachycardia effect caused by KET. 16,20,43 Moreover, the use of DEX and FENT reduces anesthetic requirements.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Ketamine Versus Ketamine-Fentanyl-Dexmedetomidine Combination for Anesthesia and Analgesia in Rats

Peng

et al. 2019

Dose-Response

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Ketamine (KET), a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, is most frequently used as an anesthetic, analgesic, and sedative drug in pediatric clinical practices. However, the adverse effects of KET administration such as psychotic episodes limited the use of KET. The aim of the present study was to evaluate whether the addition of small doses of fentanyl (FENT) and dexmedetomidine would reduce the overall KET consumption without concession on the safety and efficacy of anesthesia and analgesia in rats. We compared the effects of KET (50 mg/kg) administration alone and KET (25 mg/kg) combined with FENT (0.005 mg/kg) and dexmedetomidine (0.05 mg/kg) (KFD) on the times of onset and duration of anesthesia and analgesia. Compared with the KET group, the KFD group provides similar onset time of anesthesia, but longer duration of anesthesia, and better analgesic effect. Unlike the KET group, the KFD group had a lower heart rate and higher respiratory rate. Meanwhile, KFD induced markedly changes in the electroencephalography (EEG) spectral power when compared with control and KET. Furthermore, combination of FENT and dexmedetomidine alleviated the liver toxicity of KET. These results indicated that, when compared with KET alone, the administration of KFD combination offered safer and more efficient anesthesia.

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“…The KFD combination provides a stable anesthesia and alleviates the tachycardia effect caused by KET. 16,20,43 Moreover, the use of DEX and FENT reduces anesthetic requirements.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Ketamine Versus Ketamine-Fentanyl-Dexmedetomidine Combination for Anesthesia and Analgesia in Rats

Peng

et al. 2019

Dose-Response

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“…Several studies have shown that fentanyl is absorbed rapidly and reaches the maximum serum level in around 2 minutes with few cardiovascular effects without histamine release. It is suggested to be 75–100 times more effective than morphine (14,15). However, fentanyl has several side effects such as nausea and vomiting, bradycardia and respiratory depression, which are often in a dose-related manner (15).…”

Section: Introductionmentioning

confidence: 99%

“…It is suggested to be 75–100 times more effective than morphine (14,15). However, fentanyl has several side effects such as nausea and vomiting, bradycardia and respiratory depression, which are often in a dose-related manner (15). Importantly, it has also been reported that fentanyl may protect the heart from post-ischemic injury (16).…”

Section: Introductionmentioning

confidence: 99%

Protective effects of fentanyl preconditioning on cardiomyocyte apoptosis induced by ischemia-reperfusion in rats

Fan

et al. 2017

Braz J Med Biol Res

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We aimed to study the effect of fentanyl (Fen) preconditioning on cardiomyocyte apoptosis induced by ischemia-reperfusion (I/R) in rats. A total of 120 Sprague Dawley male rats (age: 3 months) were randomly divided into: sham operation group (S group), I/R group, normal saline I/R group (NS group), and fentanyl low, middle, and high dose groups (Fen1: 2 μg/kg; Fen2: 4 μg/kg; Fen3: 6 μg/kg). Heart rate (HR), mean arterial pressure (MAP), left ventricular developed pressure (LVDP), ±dp/dtmax, malondialdehyde (MDA), superoxide dismutase (SOD) activity, creatine phosphokinase-MB (CK-MB), and cardiac troponin-I (cTnI) were measured. Myocardial ischemic (MI) area, total apoptotic myocardial cells, and protein and mRNA expressions of B-cell lymphoma 2 (Bcl-2) and Bax were detected. HR and MAP were higher, while LVDP and ±dp/dtmax were close to the base value in the Fen groups compared to those in the I/R group. Decreased MDA concentration and CK-MB value and increased SOD activity were found in the Fen groups compared to the I/R group, while cTnI concentration was significantly lower in the Fen1 and Fen2 groups (all P<0.05). Myocardial damage was less in the Fen groups compared to the I/R group and the MI areas and apoptotic indexes were significantly lower in the Fen1 and Fen2 groups (all P<0.05). Furthermore, significantly increased protein and mRNA expressions of Bcl-2, and decreased protein and mRNA expressions of Bax were found in the Fen groups compared to the I/R group (all P<0.05). Fentanyl preconditioning may suppress cardiomyocyte apoptosis induced by I/R in rats by regulating Bcl-2 and Bax.

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“…Of which 7 studies were excluded due to duplication. The full text was retrieved for the remaining 328 studies, 324 studies were excluded and 4 studies (5,(11)(12)(13) were selected for the final analysis after detailed evaluations.…”

Section: General Characteristic Of the Included Studiesmentioning

confidence: 99%

Transdermal fentanyl patch provides better pain relief and faster functional recovery after total knee arthroplasty:a meta-analysis

Wu¹,

Li²,

Liu³

et al. 2020

Preprint

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Background : Pain after total knee arthroplasty (TKA) was severe and should be effectively managed. This meta-analysis aimed to compare transdermal fentanyl patch (TFP) versus placebo for pain control after TKA. Methods : PubMed, Embase, Cochrane library and Chinese National Knowledge Infrastructure (CNKI) were electronically searched. Potential clinical studies that investigated the effect and safety of TFP versus control in TKA patients were searched. The primary outcomes were total morphine consumption. Stata 12.0 was used for meta-analysis. Results : Four randomized controlled trials (RCTs) involving 110 TKA patients were included in this meta-analysis. Compared with control group, TFP was associated with a reduction of total morphine consumption (WMD: -16.14; 95% CI: -25.82 to -6.46; P=0.001). Moreover, TFP could significantly reduce VAS at 2 h, 4 h, 6 h, 12 h, 24 h, 48 h and 72 h (P<0.05). There was no statistically significance between the nausea, vomiting, hypertension, sweating, respiratory depression, pruritus and urine retention (P>0.05). Conclusion : The present meta-analysis showed that use of TFP for the management of moderate or severe TKA postoperative pain had more advantages compared to placebo. Further large-scale, prospective RCTs are required to verify the effect of TFP and optimal dose of TFP in TKA patients.

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Reduced morphine consumption and pain severity with transdermal fentanyl patches following total knee arthroplasty

Abstract: Transdermal fentanyl patches provide effective pain relief and decrease total rescue morphine consumption during the first 72 h after operation without additive side effects in patients undergoing TKA surgery.

Cited by 14 publications

References 25 publications

Safety and Efficacy of Ketamine Versus Ketamine-Fentanyl-Dexmedetomidine Combination for Anesthesia and Analgesia in Rats

Safety and Efficacy of Ketamine Versus Ketamine-Fentanyl-Dexmedetomidine Combination for Anesthesia and Analgesia in Rats

Protective effects of fentanyl preconditioning on cardiomyocyte apoptosis induced by ischemia-reperfusion in rats

Transdermal fentanyl patch provides better pain relief and faster functional recovery after total knee arthroplasty:a meta-analysis

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