British Journal of Anaesthesia, 1988, Vol. 60, No. 6 608-613
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia
research-article |
POSTOPERATIVE ANALGESIA WITH FENTANYL: PHARMACOKINETICS AND PHARMACODYNAMICS OF CONSTANT-RATE I.V. AND TRANSDERMAL DELIVERY
FREDERICK O. HOLLEY, M.D,; CAROL VAN STEENNIS, R.N.; Department of Anesthesia, Stanford University School of Medicine, Stanford, California 94305, and Anesthesiology Service (112a), Veterans Administration Medical Center, 3801 Miranda Avenue, Palo Alto, California 94304, U.S.A.
We have investigated the use of constant-rate delivery of fentanyl by i.v. and transdermal routes for the treatment of pain after major surgery. Forty-five males, ASA I–III, received in a doubleblinded fashion either placebo (n = 6) or fentanyl (n = 39) i.v. at one of four dose rates (25, 50, 100 or 125 µg h–1). Stable serum concentrations of fentanyl were produced by the end of surgery and were maintained for a total of 24 h. Calculated clearance of fentanyl was 1.05±0.38 litre min–1 and was not related to weight or age. Both the 100- and 125-µg h–1 dose rates produced significant analgesic efficacy as assessed by postoperative morphine requirements. Mean serum concentrations of fentanyl in these groups were 1.42±0.14 (SD) and 1.90±0.30 ng ml–1, respectively. One of 10 patients receiving fentanyl 100 µg h–1 and three of nine patients receiving 125 µg h–1 had evidence of respiratory depression. Eight additional patients were treated with a transdermal drug delivery system containing fentanyl (TTS-fentanyl). Steady-state serum concentrations in this group were 2.15±0.92 (SD) ng ml–1. Postoperative morphine requirements were minimal (< 0.5 mg h–1) and PaCO2 remained acceptable in all patients. Serum concentrations of fentanyl increased slowly (15 h to plateau) and decreased slowly (apparent half-life, 21 h). We conclude that delivery of analgesic doses of fentanyl is feasible by the transdermal route.
Presented, in part, at the Annual Meeting of the American Society of Anesthesiologists, Las Vegas, Nevada, October, 1986.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. Power Fentanyl HCl iontophoretic transdermal system (ITS): clinical application of iontophoretic technology in the management of acute postoperative pain Br. J. Anaesth., January 1, 2007; 98(1): 4 - 11. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ripamonti and E. Bruera Review articles : Transdermal and inhalatory routes of opioid administration: the potential application in cancer pain Palliative Medicine, April 1, 1992; 6(2): 98 - 104. [Abstract] [PDF]
|
|
|
|
 |
|
 D. S. Stevens and W. T. Edwards Management of Pain in the Critically Ill J Intensive Care Med, November 1, 1990; 5(6): 258 - 291. [Abstract] [PDF]
|
|
|
|
 |
|
 R. A. Caplan, L. B. Ready, R. V. Oden, F. A. Matsen III, M. L. Nessly, and G. L. Olsson Transdermal Fentanyl for Postoperative Pain Management: A Double-blind Placebo Study JAMA, February 17, 1989; 261(7): 1036 - 1039. [Abstract] [PDF]
|
|