Limits...
Acute postoperative pain management: focus on iontophoretic transdermal fentanyl.

Mattia C, Coluzzi F - Ther Clin Risk Manag (2007)

Bottom Line: Although patient-controlled analgesia (PCA) has demonstrated efficacy and patient satisfaction, current techniques using intravenous (IV) administration present limitations, including the risk of programming errors and the potential to limit patient mobility due to pumps, lines, and tubing.Fentanyl ITS is an innovative, needle-free, self-contained drug-delivery system that uses iontophoretic technology to deliver fentanyl through the skin by application of a low-intensity electrical field.The results of several clinical studies are presented in this review.

View Article: PubMed Central - PubMed

Affiliation: ICOT-Polo Pontino, Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University "La Sapienza" Roma, Italy.

ABSTRACT
Despite progress in the management of chronic pain, acute pain remains an issue for many postoperative patients. Although patient-controlled analgesia (PCA) has demonstrated efficacy and patient satisfaction, current techniques using intravenous (IV) administration present limitations, including the risk of programming errors and the potential to limit patient mobility due to pumps, lines, and tubing. The patient-controlled fentanyl hydrochloride (HCl) iontophoretic transdermal system (fentanyl ITS) was designed to address these concerns. Fentanyl ITS is an innovative, needle-free, self-contained drug-delivery system that uses iontophoretic technology to deliver fentanyl through the skin by application of a low-intensity electrical field. The results of several clinical studies are presented in this review. In three phase 3 placebo-controlled trials, fentanyl ITS was shown to be superior to placebo for the treatment of postoperative pain following major abdominal, orthopedic, and thoracic surgery. The results of one active-comparator phase 3 trial demonstrated comparable safety and efficacy with a standard morphine IV PCA dosing regimen, without significant difference in the side effect profile. Fentanyl ITS represents a safe, easy to use, non-invasive, and convenient alternative to current acute postoperative pain management modalities.

No MeSH data available.


Related in: MedlinePlus

Percentage of patients rating pain control as “good” or “excellent” in the active-controlled trial (Viscusi et al 2004).Abbreviations: fentanyl ITS, fentanyl hydrochloride iontophoretic transdermal system; IV, intravenous; PCA, patient-controlled analgesia.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC1936285&req=5

fig3: Percentage of patients rating pain control as “good” or “excellent” in the active-controlled trial (Viscusi et al 2004).Abbreviations: fentanyl ITS, fentanyl hydrochloride iontophoretic transdermal system; IV, intravenous; PCA, patient-controlled analgesia.

Mentions: In 2004, the results of the first study comparing the efficacy of fentanyl ITS with morphine IV PCA were published (Viscusi et al 2004). In this prospective, parallel-group trial, 636 patients were assigned randomly to receive IV morphine (1 mg dose as a bolus, with a 5 min lockout and a maximum of 10 mg/h) by PCA pump (n=320) or fentanyl ITS (40 μg treatment over 10 min; n=316) (Viscusi et al 2004). Most patients were female (72.5%), white (73.7%), and had undergone major abdominal, orthopedic, or thoracic surgery. Both modalities were therapeutically equivalent according to pain intensity scores at all assayed time points during the 24 h treatment period, and the distribution of patients’ ratings of pain control as poor, fair, good, or excellent between treatment groups were not statistically different. Assessment of successful global pain management was determined by combining patients’ ratings of pain control as good and excellent for each modality. These values were similar for fentanyl ITS and morphine IV PCA (73.7% and 76.9%, respectively; p=0.36) (Figure 3), further suggesting therapeutic equivalence between the 2 PCA systems.


Acute postoperative pain management: focus on iontophoretic transdermal fentanyl.

Mattia C, Coluzzi F - Ther Clin Risk Manag (2007)

Percentage of patients rating pain control as “good” or “excellent” in the active-controlled trial (Viscusi et al 2004).Abbreviations: fentanyl ITS, fentanyl hydrochloride iontophoretic transdermal system; IV, intravenous; PCA, patient-controlled analgesia.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1936285&req=5

fig3: Percentage of patients rating pain control as “good” or “excellent” in the active-controlled trial (Viscusi et al 2004).Abbreviations: fentanyl ITS, fentanyl hydrochloride iontophoretic transdermal system; IV, intravenous; PCA, patient-controlled analgesia.
Mentions: In 2004, the results of the first study comparing the efficacy of fentanyl ITS with morphine IV PCA were published (Viscusi et al 2004). In this prospective, parallel-group trial, 636 patients were assigned randomly to receive IV morphine (1 mg dose as a bolus, with a 5 min lockout and a maximum of 10 mg/h) by PCA pump (n=320) or fentanyl ITS (40 μg treatment over 10 min; n=316) (Viscusi et al 2004). Most patients were female (72.5%), white (73.7%), and had undergone major abdominal, orthopedic, or thoracic surgery. Both modalities were therapeutically equivalent according to pain intensity scores at all assayed time points during the 24 h treatment period, and the distribution of patients’ ratings of pain control as poor, fair, good, or excellent between treatment groups were not statistically different. Assessment of successful global pain management was determined by combining patients’ ratings of pain control as good and excellent for each modality. These values were similar for fentanyl ITS and morphine IV PCA (73.7% and 76.9%, respectively; p=0.36) (Figure 3), further suggesting therapeutic equivalence between the 2 PCA systems.

Bottom Line: Although patient-controlled analgesia (PCA) has demonstrated efficacy and patient satisfaction, current techniques using intravenous (IV) administration present limitations, including the risk of programming errors and the potential to limit patient mobility due to pumps, lines, and tubing.Fentanyl ITS is an innovative, needle-free, self-contained drug-delivery system that uses iontophoretic technology to deliver fentanyl through the skin by application of a low-intensity electrical field.The results of several clinical studies are presented in this review.

View Article: PubMed Central - PubMed

Affiliation: ICOT-Polo Pontino, Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University "La Sapienza" Roma, Italy.

ABSTRACT
Despite progress in the management of chronic pain, acute pain remains an issue for many postoperative patients. Although patient-controlled analgesia (PCA) has demonstrated efficacy and patient satisfaction, current techniques using intravenous (IV) administration present limitations, including the risk of programming errors and the potential to limit patient mobility due to pumps, lines, and tubing. The patient-controlled fentanyl hydrochloride (HCl) iontophoretic transdermal system (fentanyl ITS) was designed to address these concerns. Fentanyl ITS is an innovative, needle-free, self-contained drug-delivery system that uses iontophoretic technology to deliver fentanyl through the skin by application of a low-intensity electrical field. The results of several clinical studies are presented in this review. In three phase 3 placebo-controlled trials, fentanyl ITS was shown to be superior to placebo for the treatment of postoperative pain following major abdominal, orthopedic, and thoracic surgery. The results of one active-comparator phase 3 trial demonstrated comparable safety and efficacy with a standard morphine IV PCA dosing regimen, without significant difference in the side effect profile. Fentanyl ITS represents a safe, easy to use, non-invasive, and convenient alternative to current acute postoperative pain management modalities.

No MeSH data available.


Related in: MedlinePlus