The Effects of Oral Transmucosal Fentanyl Citrate Premedication on Gastric Volume and Acidity in Children

Leiman, Basil C.; Walford, A. J.; Rawal, N.; Katz, J.; Marcus, Marianne T.; Nieuwenhuyzen, H.; Cronau, L. H.; Stanley, T. H.

doi:10.1097/00000542-198709001-00489

Cited by 6 publications

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“…Recent developments suggest that nasal ( 1 4 ) and buccal (5-9) mucous membranes and skin (10)(11)(12) may serve as alternative routes for drug administration. New devices and techniques for drug delivery systems include transdermal and transmucosal controlled release delivery systems (1 3 ) , nasal and buccal aerosol sprays ( 13) and drug-impregnated lollipops (5)(6)(7)(8). Reported advantages of the new routes of ad- Table 5 Side effects during the entire study.…”

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confidence: 99%

Transnasal butorphanol: a new method for pain relief in post‐cesarean section pain

Abboud

Zhu

Gangolly

et al. 1991

Acta Anaesthesiol Scand

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This study was undertaken to evaluate the efficacy and the safety of transnasal butorphanol (TNB) compared to intravenous butorphanol (IVB) in 186 patients experiencing moderate to severe post-cesarean section pain. Patients were randomly assigned to five groups in a double-blind fashion: Group I (n = 37) received 2 mg IVB, Group II (n = 38) 2 mg TNB, Group III (n = 36) 1 mg TNB followed by a repeat dose of 1 mg TNB at 60 min, Group IV (n = 38) 0.5 mg TNB followed by a repeat dose of 0.5 mg at 60 min, and Group V (n = 37) received placebo. All administrations were double dummy. Pain intensity and relief were noted and the incidence of side effects was recorded. Remedication with the same study drug was allowed up to 72 h. Onset of analgesia was more rapid in the 2 mg IV group compared to the three TN groups: 5 min vs 15 min, respectively. However, the 2 mg and the 1-1 mg TN groups had a longer duration of analgesia, approximately 4.5 h, compared to 3.0 h for the 2 mg IV group (P less than 0.05). Somnolence was dose related and was the most frequent side effect, and was less frequent when the TN dose was divided into 2 doses administered 1 h apart. Multiple doses of TNB and IVB were safe and clinically acceptable up to 3 days at all doses studied. There were no incidences of nasal mucosa irritation, or cardiovascular or respiratory depression. It is concluded that transnasal butorphanol represents a safe and effective alternative to injectable butorphanol for post-cesarean section pain and offers a better and longer duration of analgesia compared to IV butorphanol. The optimum dose seems to be 2 mg TN butorphanol and it is tolerated better when divided into 1 mg increments, given 1 h apart.

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