• Ayşegül Bilen, Achmet Ali, Fulya Baturay, and Aysel Altan.
• Department of Anesthesiology and Reanimation, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
• Agri. 2010 Jul 1; 22 (3): 103-8.

ObjectivesWe aimed to search the frequency of breakthrough pain (BP) and the efficiency of oral transmucosal fentanyl citrate (OTFC) for the treatment of BP in cancer patients.MethodsOne hundred twenty-four patients who had used strong opioid analgesics for more than one month were included in the study. The frequency of BP in those patients was determined. Fifty-two of the patients who described BP and complied with the inclusion criteria for the study were included in our study. Appropriate dose of OTFC to take those patients to titration phase for 3 days was determined. Titration phase was started with 200 µg OTFC, and 800 µg was established as the maximum dose. The patients were monitored for a further 10 days after the titration phase. Using the Breakthrough Pain Questionnaire, the efficiency of OTFC (with Pain Relief Score), duration of effect, side effects, and visual analogue scale (VAS) values before and after OTFC were recorded.ResultsThe frequency of BP was found as 63.7% in our study. The appropriate OTFC dose in the titration phase was found as 200 µg for 10 patients, 400 µg for 21 patients, and 800 µg for 17 patients; in 4 patients, OTFC failed to control their BP attacks. An appropriate dose of OTFC was found effective in 81.1% of BP attacks. A significant difference was determined in VAS scores before and after OTFC use (p<0.001). The average duration effect of OTFC was determined as 17.7 ± 8.28 minutes. No serious side effect was reported in any patient.ConclusionOTFC is effective and reliable in the treatment of BP attacks in cancer patients.

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