Equipotent doses of transdermal fentanyl and transdermal buprenorphine in patients with cancer and noncancer pain: Results of a retrospective cohort study

Sittl, Reinhard; Likar, Rudolf; Nautrup, B Poulsen

doi:10.1016/j.clinthera.2005.02.012

Cited by 87 publications

(74 citation statements)

References 14 publications

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“…A dose total de opiói-des nas 24 horas que antecederam a entrada no estudo, foi registada em dose equivalente de morfina oral (DEMD), em miligramas (mg), de acordo com a tabela de conversão de opióides de Sittl R et al 16,17 Por outro lado, fármacos como o paracetemol, metamizol, e os anti-inflamatórios não esteróides (AINES) foram classificados como analgésicos não-opióides, de acordo com a escada analgésica da OMS para doentes oncológicos. 18 Os fármacos: haloperidol, olanzapina, quetiapina, risperidona, foram classificados como neurolépticos.…”

Section: Instrumentos E Métodos De Recolha De Dadosunclassified

Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

et al. 2016

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Introduction:Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values. Material and Methods:This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain. Results: Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 -94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 -2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 -46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 -37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 -63) (p = 0.022). Discussion: The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care. Conclusion: Cancer pain continues to be a major clinical problem in advanced cancer patients. Keywords: Neoplasms; Pain Measurement; Palliative Care. INTRODUÇÃOA dor é uma experiência subjetiva e multidimensional, frequentemente relatada nos doentes oncológicos, principalmente nos que se encontram numa fase mais avançada da sua doença.1-3 Do mau controlo sintomático que está associado à fase avançada do cancro, a dor é o sintoma que frequentemente surge descrito como o mais angustiante, tendo elevado impacto negativo na qualidade de vida e deteriorando a capacidade do doente em aderir ao tratamento oncológico ou alcançar uma morte tranquila.

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Section: Instrumentos E Métodos De Recolha De Dadosunclassified

Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

et al. 2016

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“…En fait, il n'y a pas de plafond pour l'analgésie avec la buprénorphine, et ce médicament a été utilisé de façon concluante dans des cas de douleur cancéreuse et non cancéreuse grave durant plusieurs mois. [10][11][12] Ce paradoxe apparent, soit un potentiel analgésique illimité combiné à un plafond des effets indésirables, a l'air trop beau pour être vrai. L'explication pourrait se trouver dans le fait que la buprénorphine a un effet différentiel, d'où sa puissance supérieure aux sites de récepteurs rachidiens qu'aux sites de récepteurs opioïdes cérébraux, ces derniers étant évidemment le site de génération des effets indésirables médiés par le système nerveux central.…”

Section: La Buprénorphineunclassified

“…In fact, there is no ceiling for buprenorphine analgesia, and it has been used to good effect even in severe cancer and non-cancer pain lasting many months. [10][11][12] This apparent paradox, i.e., unlimited analgesic potential combined with a ceiling on adverse effects, sounds almost too good to be true. The explanation may lie in the observation that buprenorphine has a differential effect, which results in its being more potent at spinal receptor sites than at cerebral opioid receptor sites, the latter obviously being where centrally-mediated adverse effects would be generated.…”

Section: Buprenorphinementioning

confidence: 99%

Perioperative considerations for “new” kids on the opioid block

Moyo

Rashiq

2011

Can J Anesth/J Can Anesth

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“…12 It is 100 times more potent than morphine resulting in an estimated conversion ratio of 1:100, in order to provide an equal degree of analgesia. 13,14 Its low molecular weight, high potency and lipid solubility make it ideal for delivery via the transdermal route. Matrix patches (e.g.…”

Section: Fentanylmentioning

confidence: 99%

Transdermal Opioids for Cancer Pain Management

Vithlani

Baranidharan

2010

Reviews in Pain

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Leeds Teaching Hospitals NHS Trust, Seacroft Hospital, Leeds, LS14 6UH, Email g.baranidharan@nhs.net s u m m a r y p o i n t s• The prevalence of pain in cancer is up to 90%, more than 45% of this can be adequately managed using the World Health Organisation three step analgesic ladder.• Transdermal opioids are safe, effective, and produce significantly fewer side effects than oral morphine when used for moderate to severe cancer pain.• Transdermal buprenorphine has a lower incidence of systemic side effects than transdermal fentanyl and it is indicated for use in cancer patients with neuropathic pain and renal dysfunction.• Transdermal opioids require a long lag period for dose stabilisation and elimination, hence are unsuitable for acute or unstable pain, and may result in prolonged side effects.• Transdermal analgesics reduce the need for frequent dosing, clock watching and are more convenient for patients, physicians and carers, hence increasing treatment compliance.

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Equipotent doses of transdermal fentanyl and transdermal buprenorphine in patients with cancer and noncancer pain: Results of a retrospective cohort study

Cited by 87 publications

References 14 publications

Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

Perioperative considerations for “new” kids on the opioid block

Transdermal Opioids for Cancer Pain Management

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