• Alan David Kaye, Bethany L Menard, Ken P Ehrhardt, Sonja A Gennuso, Eva C Okereke, Sridhar R Tirumala, Charles J Fox, and Elyse M Cornett.
• Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave, New Orleans, LA, 70112, USA.
• Curr Pain Headache Rep. 2019 Jun 21; 23 (7): 50.

Purpose Of ReviewThe administration of a transdermal fentanyl patch can be complicated with different pharmacokinetics than other fentanyl preparations.Recent FindingsThe medical condition and baseline opioid requirements must all be carefully considered when dosing a fentanyl patch. An advantage of the fentanyl patch is its ability to bypass the gastrointestinal tract and in many patients, provide effective analgesia with minimal side effects. Fentanyl patches must be carefully administered since morbidity and/or mortality can result from the following: Giving higher doses than a patient needs, combining the medication with potent sedatives, or heating a fentanyl patch. The use of a transdermal fentanyl patch for the treatment of acute postoperative pain is not recommended and any patient undergoing a surgical procedure should have the fentanyl patch removed preoperatively. The current manuscript discusses the history of fentanyl and the fentanyl patch, as well as perioperative considerations, contraindications, current clinical efficacy, and clinical adversities related to the transdermal fentanyl patch. Regarding the heating of a transdermal fentanyl patch, which significantly increases blood levels of fentanyl, it is of the utmost importance that the patch be removed prior to surgery.

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