Document Detail


Current practices for postoperative pain management in Europe and the potential role of the fentanyl HCl iontophoretic transdermal system.
MedLine Citation:
PMID:  17156510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Survey results continue to reveal that postoperative pain is insufficiently managed throughout Europe and the rest of the world. However, the efficient use of existing resources, as well as the introduction of novel technologies, may aid in its improvement. Use of an acute pain service has the potential to improve pain management through specialized patient care and utilization of effective analgesic techniques. Multimodal analgesic techniques, which include adjuvant non-opioids and/or regional analgesic techniques, can provide effective analgesia and reduce the amount of systemic opioids (or obviate the need) for postoperative pain management. Patient-controlled analgesia modalities may also offer improvements to pain management, as in practice they provide pain relief superior to the intermittent administration of bolus doses of opioids. A novel patient-controlled analgesia modality that has been approved by the European Medicines Evaluation Agency (EMEA) for the treatment of acute, moderate-to-severe pain is the needle-free, pre-programmed fentanyl HCl iontophoretic transdermal system. This system was shown in a recent US clinical trial to be comparable in efficacy to a standard regimen of morphine intravenous patient-controlled analgesia. Adverse events associated with the use of the fentanyl iontophoretic transdermal system are generally similar to those experienced by patients using intravenous morphine patient-controlled analgesia. Considerations regarding the selection of patients for treatment with the fentanyl iontophoretic transdermal system are similar to those with other patient-controlled analgesia modalities; sufficient upper limb mobility and alertness are required to operate the system. Utilization of the fentanyl iontophoretic transdermal system, together with the guidance of an effective acute pain service, may lead to improvements in postoperative pain management.
Authors:
N Rawal; R M Langford
Publication Detail:
Type:  Journal Article; Review     Date:  2006-12-08
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  24     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-02-14     Completed Date:  2007-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  299-308     Citation Subset:  IM    
Affiliation:
Orebro University Hospital, Department of Anaesthesiology and Intensive Care, Orebro, Sweden. n.rawal@orebroll.se
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Analgesia, Epidural
Analgesia, Patient-Controlled
Analgesics / administration & dosage
Analgesics, Opioid / administration & dosage*
Fentanyl / administration & dosage*
Humans
Iontophoresis*
Pain, Postoperative / drug therapy*
Chemical
Reg. No./Substance:
0/Analgesics; 0/Analgesics, Opioid; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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