The effectiveness of a long‐acting transdermal fentanyl solution compared to buprenorphine for the control of postoperative pain in dogs in a randomized, multicentered clinical study

Abstract

The effectiveness of a long-acting transdermal fentanyl solution compared to buprenorphine for the control of postoperative pain in dogs in a randomized, multicentered clinical study. J. vet. Pharmacol. Therap. 35 (Suppl. 2), 53-64.A prospective, double-blinded, positive-controlled, multicenter, noninferiority clinical study was conducted to evaluate the safety and effectiveness of a longacting transdermal fentanyl solution (TFS) for the control of postoperative pain. Four hundred forty-five client-owned dogs of various breeds were randomly assigned to receive a single dose of TFS (2.6 mg ⁄ kg [50 lL ⁄ kg]) (N = 223) applied 2-4 h prior to surgery or buprenorphine (20 lg ⁄ kg) (N = 222) administered intramuscularly 2-4 h prior to surgery and every 6 h through 90 h. There were 159 (35.7%) males and 286 (64.3%) females ranging from 0.5 to 16 years of age and 3 to 98.5 kg enrolled. Pain was scored using the modified Glasgow Composite Pain Scale with an a priori dropout criteria of ‡8 (20 maximum score). The one-sided upper 95% confidence interval of the mean difference between fentanyl and buprenorphine treatment failures was 5.6%, which was not greater than the a priori selected margin difference of 15%. Adverse events attributed to either treatment were minimal in impact and were approximately equal between groups. Sustained plasma fentanyl concentrations provided by a single pre-emptive dose of TFS are safe and effective and are noninferior to repeated injections of buprenorphine in controlling postoperative pain over 4 days. This long-acting fentanyl formulation provides veterinarians with a novel, registered option for the control of postoperative pain in dogs that improves dosing compliance and potentially mitigates the disadvantages of oral, parenteral, and patch delivered opioids.

Analgesia in the Perioperative Period

“…10 When compared with intermittent injection of other opioids (buprenorphine and oxymorphone), this formulation was found to be effective and safe. 11,12 It should also be noted that the opioid antagonist naloxone was able to reverse the effects of overdose when administered at hourly intervals. 13 Because this product is approved for dogs and reduces the chance for accidental human exposure, it is recommended that it be used in place of the commercially available human transdermal patches.…”

The pharmacokinetics and analgesic effects of extended‐release buprenorphine administered subcutaneously in healthy dogs

“…(Morgaz et al., ), subcutaneous (s.c.) (Moll, Fresno, Garcia, Prandi, & Andaluz, ), intramuscular (i.m.) (Linton, Wilson, Newbound, Freise, & Clark, ), transdermal (Moll et al., ), and oral transmucosal (Ko et al., ), have been previously studied in dogs, with the i.v. and i.m.…”

Gestion de la douleur en chirurgie vétérinaire : aspects éthiques et pratiques chez le chien

“…Afin d'éviter le maintien d'une voie intraveineuse sur une longue durée, il est aussi possible d'administrer le fentanyl par timbres cutanés (Reed et al 2011) ou en solution transdermique (Linton et al 2012). Ces voies d'application permettent le traitement de la douleur pendant plusieurs jours mais ont le désavantage d'un mauvais contrôle du niveau de l'analgésie et de ses effets secondaires.…”