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Vol 3, No 1 (2004): Polish Palliative Medicine
Original articles
Published online: 2003-10-27
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Evaluation of the effectiveness of oral transmucosal fentanyl in the treatment of breakthrough pain in cancer patients

Monika Rucińska, Piotr Jakubów, Dariusz Kożuchowski, Jakub Jabłoński, Jan J. Braszko, Marek Z. Wojtukiewicz
Advances in Palliative Medicine 2004;3(1):3-8.

open access

Vol 3, No 1 (2004): Polish Palliative Medicine
Original articles
Published online: 2003-10-27

Abstract

Background. In cancer patients persistent pain can co-exist with acute, severe pain, so called breakthrough pain. This kind of pain is relatively common, and difficult to treat. Breakthrough pain is usually managed with supplemental strong and short-acting analgesic medications. The objective of this work was to evaluate effectiveness of oral transmucosal fentanyl citrate for the management of the breakthrough pain.
Materials and methods. 26 adult patients of Hospice of Białystok with persistent cancer pain were recruited into this study. Patients received transdermal fentanyl for persistent pain and oral morphine or transmucosal fentanyl for breakthrough pain. Chronic and breakthrough pain intensity, time to pain relief and patients’ satisfaction scores were recorded.
Results. The median of chronic pain intensity was 2.1 and median of breakthrough pain was 6 according to visual analogue scale (VAS). There was no difference between oral morphine and submucosal fentanyl in pain relief, but time to pain relief was significantly shorter in case of fentanyl. Plasma fentanyl concentrations ranged between 0.39 and 1.86 ng/ml and did not increase after transmucosal administration of fentanyl.
Conclusions. Transmucosal fentanyl appears effective in the management of breakthrough pain. Cancer patients found this therapy acceptable.

Abstract

Background. In cancer patients persistent pain can co-exist with acute, severe pain, so called breakthrough pain. This kind of pain is relatively common, and difficult to treat. Breakthrough pain is usually managed with supplemental strong and short-acting analgesic medications. The objective of this work was to evaluate effectiveness of oral transmucosal fentanyl citrate for the management of the breakthrough pain.
Materials and methods. 26 adult patients of Hospice of Białystok with persistent cancer pain were recruited into this study. Patients received transdermal fentanyl for persistent pain and oral morphine or transmucosal fentanyl for breakthrough pain. Chronic and breakthrough pain intensity, time to pain relief and patients’ satisfaction scores were recorded.
Results. The median of chronic pain intensity was 2.1 and median of breakthrough pain was 6 according to visual analogue scale (VAS). There was no difference between oral morphine and submucosal fentanyl in pain relief, but time to pain relief was significantly shorter in case of fentanyl. Plasma fentanyl concentrations ranged between 0.39 and 1.86 ng/ml and did not increase after transmucosal administration of fentanyl.
Conclusions. Transmucosal fentanyl appears effective in the management of breakthrough pain. Cancer patients found this therapy acceptable.
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Keywords

fentanyl; breakthrough pain

About this article
Title

Evaluation of the effectiveness of oral transmucosal fentanyl in the treatment of breakthrough pain in cancer patients

Journal

Advances in Palliative Medicine

Issue

Vol 3, No 1 (2004): Polish Palliative Medicine

Pages

3-8

Published online

2003-10-27

Bibliographic record

Advances in Palliative Medicine 2004;3(1):3-8.

Keywords

fentanyl
breakthrough pain

Authors

Monika Rucińska
Piotr Jakubów
Dariusz Kożuchowski
Jakub Jabłoński
Jan J. Braszko
Marek Z. Wojtukiewicz

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