Transdermal Fentanyl Versus Sustained Release Oral Morphine in Strong-Opioid Naïve Patients With Chronic Low Back Pain

Abstract

TDF and SRM provided equivalent levels of pain relief, but TDF was associated with less constipation. This study indicates that sustained-release strong opioids can safely be used in strong-opioid naïve patients.

Opioids in chronic noncancer pain

“…Adams et al showed that sustained release morphine significantly increased the proportion of subjects who reported an improvement in the ability for moderate-intensity activities [60]. Allan et al, in an evaluation of transdermal fentanyl or sustained-release morphine, demonstrated that, while both drugs provided significant pain relief, the proportion of participants reporting more than 3 weeks of work decreased from 34 and 25% at baseline to 16% for transdermal fentanyl and sustained release morphine at end point, respectively [44]. Zenz et al have also shown a close correlation between pain reduction and an increase in performance [46].…”

“…However, for oral opioids they evaluated morphine in three studies [44][45][46], tramadol in one study [47], methadone in one study [48], extended-release oxymorphone in one study [49], controlled-release oxycodone in one study [50], as well as dihydrocodeine and buprenorphine [46]. For evaluation of effectiveness of transdermal fentanyl they included three studies [44,51,52]; however, only two studies utilized pain relief of 50% or greater as their significant criteria [44,46]. In this study, because of high withdrawal rates, they first analyzed withdrawal rates of the two most commonly cited reasons for leaving a study, namely adverse events and insufficient pain relief [37].…”

418 the Clinical and Laboratorial Evaluation of Transdermal Ketamine, Fentanyl, Clonidine or Their Combination in Chronic Low Back Pain

“…Among opioids, T fentanyl was described as superior to oral morphine for chronic low back pain. Although daily analgesia was similar between the two opioids, T fentanyl resulted in less constipation and greater pain relief at night 9 . The drugs of the study were chosen based on actual data regarding pain processes.…”

Uso e rotação de opioides para dor crônica não oncológica

“…The weak opioids used were tramadol, propoxyphene, and codeine and the potent ones were morphine and oxycodone 3 . Some authors use transdermal fentanyl 4,5,8 . Treatment should be based on equivalent doses of opioids.…”

“…Opioids are used to relieve pain from various syndromes, such as lumbago [5][6][7] , osteoarthritis 7,8 , neuropathy 7 , rheumatoid arthritis 6 .…”