Fentanyl for Acute Pain Management

Single use of fentanyl in colonoscopy is safe and effective and significantly shortens recovery time

“…Modalities such as continuous measurement of expiratory carbon dioxide [31] deserve further investigation as tools for monitoring respiratory function. As with other hypnotics, lower initial doses and bolus increments of fentanyl and cautious titration are essential to safety in the elderly [20,23]. The results of this study also indicated that fentanyl provided adequate pain relief in our patients during colonoscopy.…”

“…FentanylÕs short duration of action makes it an appropriate first choice for IV analgesia when a goal is short recovery time such as following ambulatory surgical procedures and during painful procedures [20,21]. Indeed, the time required to reach home discharge readiness was significantly lower in the Fentanyl group; an important and frequently discussed factor influencing the general evaluation of ambulatory practice is rapid recovery time and home discharge.…”

“…The use of fentanyl in some countries requires the presence of an anesthetist, which may not be realistic in most endoscopy units. Safety aspects, such as the need for assisted ventilation in cases of apnea that has been reported to be dose-dependent at high dose levels ‡3 mcg/kg) of fentanyl, are the reason for this recommendation [11,20,23]. However, our data suggest that the application of fentanyl in low incremental bolus doses for colonoscopy may yield even better levels of safety compared with the conventional administration of midazolam and, moreover, this results in a higher level of patient satisfaction and a shorter recovery period.…”

“…Newer opiate agents such as fentanyl were designed to gain all benefits and reduce the adverse events [9,29]; these agents have rapid onset and termination of action, thereby making them ideal choices for titrated administration [17,20]. We therefore evaluated the efficacy and safety of intravenous (IV) administration of fentanyl in titrated doses in comparison to IV administration of the well-known midazolam in titrated doses.…”

Plasma Fentanyl Concentrations Achieved after Transdermal Fentanyl Patch Application in Prehensile-Tailed Skinks, Corucia zebrata

“…Currently, in small animal practice (Kyles et al, 1996;Glerum et al, 2001;Gellasch et al, 2002;Hoffmeister and Egger, 2004) and research settings for large domestic and exotic mammals (Grubb et al, 2005), transdermal fentanyl (TDF) patches (Duragesic, Janssen Pharmaceutica, Titusville, New Jersey) have been used as means of analgesia. Although in hum an medicine the primary indication for T D F is chronic, nonoperative pain (Konishi et al, 2005), it has been demonstrated clinically effective for control of peri-operative pain in cats, Felis sylvaticus (Lee et al, 2000;Glerum et al, 2001;Gellasch et al, 2002;Davidson et al, 2004); shown to achieve analge sic systemic concentrations in rabbits, Oryctolagus cuniculus (Foley et al, 2001) and dogs, Canis familiaris (Kyles et al, 1996); and more recently applied in acute (Pasero, 2005) and operative (Koo, 2005) pain control for humans.…”