Respiratory changes during treatment of postoperative pain with high dose transdermal fentanyl

  title={Respiratory changes during treatment of postoperative pain with high dose transdermal fentanyl},
  author={H-H B{\"u}low and Michael U. S. Linnemann and H Berg and Torsten Lang-Jensen and Stephen LaCour and Torsten Jonsson},
  journal={Acta Anaesthesiologica Scandinavica},
This study made a longterm (72 hours) evaluation of the efficacy and possible side‐effects of transdermal delivery of fentanyl (TTS‐system) for post‐operative pain relief. 

Severe respiratory depression and sedation with transdermal fentanyl: four case studies

Four patients with advanced cancer on transdermal (TD) fentanyl (Durogesic) develop delayed and severe respiratory depression and these cases are of concern since past and recent studies have suggested that respiratory depression with TD fentanyl is uncommon and mild.

Management of the Postoperative Pain

In recent years many advances have been made in understanding the patho-physiology and the neural pathways of pain, as well as in developing new analgesic drugs and new routes of administration.

Benefit-Risk Assessment of Transdermal Fentanyl for the Treatment of Chronic Pain

Transdermal fentanyl is indicated only for patients who require continuous opioid administration for the treatment of chronic pain that cannot be managed with other medications, as pain may decrease more rapidly in these circumstances than fentanyl blood levels can be adjusted, leading to the development of life-threatening hypoventilation.

Efficacy and safety of transdermal fentanyl in the control of postoperative pain after photorefractive keratectomy.

Evaluating the efficacy and safety of transdermal fentanyl in the control of postoperative pain following photorefractive keratectomy (PRK) found differences in mean pain intensity scores were significant between the control group and the fentanyl group.

Transdermal therapeutic fentanyl-system (TTS-F).

The transdermal therapeutic fentanyl-system (TTS-F) allows for a continued and sustained titratable amount of fentanyl to be delivered without the inconvenience of the typical 24-h administration of other analgesics.

Transdermal fentanyl patch for postoperative analgesia in total knee arthroplasty: a randomized double-blind controlled trial

TFP (50 μg/hour) applied 10–12 hours before surgery can effectively and safely decrease morphine consumption and pain scores during the first 48 hours after TKA surgery.

Transdermal fentanyl as an adjuvant to paravertebral block for pain control after breast cancer surgery: A randomized, double-blind controlled trial

TFPs releasing 25 μg/h is a safe and effective adjuvant to PVB after breast cancer surgery that provides adequate analgesia with reduction of opioid consumption and minimal adverse effects.

Opioids, respiratory function, and dyspnea

Current knowledge in the pathophysiology of dyspnea, proposed opioid mechanism of action, and evidence of efficacy are reviewed.

Transdermal Fentanyl

Transdermal fentanyl is a useful alternative to other opioid agents, which is also recommended on the third step of the WHO analgesic ladder, in the management of chronic malignant pain and preliminary data indicate that it may be useful in themanagement of chronic nonmalignant pain.

The fentanyl story.

  • T. Stanley
  • Medicine
    The journal of pain : official journal of the American Pain Society
  • 2014



Transdermal fentanyl for the relief of pain after upper abdominal surgery.

Transdermal fentanyl was compared with placebo in a double-blind study of pain after upper abdominal surgery and pain scores were significantly lower and peak expiratory flow rates significantly higher in the transdermalentanyl group, who demanded significantly less morphine than the control group.

Transdermal fentanyl for postoperative pain management. A double-blind placebo study.

The incidence of vomiting, respiratory rate, and respiratory rate in the active group was lower than in the placebo group during the 13- to 24-hour interval of system application, and transdermal fentanyl appears to be safe and effective after orthopedic surgery in healthy adult patients.

Postoperative analgesia with fentanyl: pharmacokinetics and pharmacodynamics of constant-rate i.v. and transdermal delivery.

Serum concentrations of fentanyl increased slowly (15 h to plateau) and decreased slowly (apparent half-life, 21 h) and it is concluded that delivery of analgesic doses of fentanyl is feasible by the transdermal route.

Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern.

It is concluded that postoperative sleep pattern is disturbed severely with early depression of REM and slow wave sleep and with rebound of REM sleep on the second and third nights.

Kehlet H . Late postoperative nocturnal episodic hypoxdemia and associated sleep pattern

  • BrJAnaesth
  • 1994

: pharmacokinetics and pharmacodynamic effects

  • 1989