Journal of pain and symptom management
-
The transdermal therapeutic system (TTS) is a novel technique of drug administration that can mimic long-term continuous intravenous infusions in maintaining stable drug plasma concentrations. Fentanyl, a potent lipid-soluble synthetic opioid, has been incorporated into such a system and has undergone preliminary clinical trials in postoperative patient populations to assess analgesic efficacy and incidence of undesirable side effects (pruritus, nausea and vomiting, urinary retention, respiratory depression). In general, when applied 2 hr preoperatively, a TTS (fentanyl) patch (in different doses) provides moderate-to-good analgesia for a variety of surgical procedures for periods of up to 3 days. ⋯ The incidence of side effects such as nausea and vomiting varies between studies but can be as high as 70%. Clinically significant respiratory depression is rare but was reported in several of the studies. TTS (fentanyl) is a simple and useful technique for the control of postoperative pain.
-
Alternative routes of drug delivery have particular relevance for use in chronic pain. When the pain experience is constant or nearly constant, a continuous infusion of drug is an ideal way to achieve effective pain relief. Early experience with the transdermal application of fentanyl in chronic cancer pain suggests that it is a safe, noninvasive, effective method of managing pain. ⋯ The system was able to be maintained through a variety of concomitant events. This experience demonstrated the safety and clinical effectiveness of transdermal fentanyl. The transdermal therapeutic system (fentanyl) is a promising advance in achieving noninvasive, continuous drug administration for the management of chronic cancer pain.
-
J Pain Symptom Manage · Apr 1992
ReviewThe role of patient-controlled analgesia in the management of cancer pain.
The technology of patient-controlled analgesia (PCA) has gained wide acceptance for use in cancer pain management. Assessment of technological innovations is necessary in order to evaluate the most appropriate use from the perspective of the individual patient and broader health policy perspective. This paper reviews the literature related to PCA use in chronic cancer pain, appropriate and inappropriate uses of PCA, as well as several professional issues and directions for future PCA use. Professional dialogue regarding the standard of PCA care is necessary for optimum use of this technology for relief of chronic pain.
-
Cough is a distressing and disabling symptom in cancer patients. Based on an understanding of the physiology of the cough reflex and the pathophysiology of cough in cancer patients, a systematic approach to the management of this symptom is presented.
-
This article reviews the currently published articles regarding the use of spinal opioids in pediatric patients and discusses the important clinical considerations for the application and monitoring of this technique in children.