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Cited by 13Pain Management and Opioid UseAnesthesia and Pain ManagementPain Management and Treatment

Patient-Controlled Transdermal Fentanyl Versus Intravenous Morphine Pump After Spine Surgery

Lindley, Emily M., Milligan, Kenneth, Farmer, Ryan, Burger, Evalina L., Patel, Vikas V.·2015·Orthopedics
DOI 10.3928/01477447-20150902-61
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Abstract

Patient-controlled analgesia (PCA) is regularly used to manage pain following major surgery. The fentanyl hydrochloride iontophoretic transdermal system (ITS) was developed to overcome some of the limitations of intravenous (IV) PCA. The small, self-adhesive, needle-free disposable system is applied to the skin on the upper arm or chest and is controlled by patients clicking a button on the device. The authors identified patients who were underwent spinal surgery from 2 prior multicenter, randomized studies and analyzed their data. Of the 1296 patients in the original trials, 170 underwent spine surgery procedures: 90 were randomized to the fentanyl ITS (40 mcg/activation) and 80 to IV PCA morphine (1 mg/dose). More patients treated with the fentanyl ITS rated their method of pain control as “excellent” across all time points, but differences did not reach statistical significance. However, investigators’ ratings of “excellent” satisfaction with study treatment were significantly higher for the fentanyl ITS. Discontinuation rates and overall adverse event rates were similar between groups. The only significant difference was that patients treated with the fentanyl ITS had a higher rate of application site reactions than infusion site reactions in the IV PCA morphine group; the reactions were typically mild-to-moderate erythema that resolved shortly after removal of the fentanyl ITS device and did not require further treatment. Ratings of satisfaction with pain control method were consistently higher for the fentanyl ITS than the IV PCA morphine. The 2 groups had a similar safety profile. These results suggest that the fentanyl ITS appears to be a safe, efficacious alternative to IV PCA in spine surgery patients. [ Orthopedics. 2015; 38(9):e819–e824.]

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Authors
Lindley, E. M., Milligan, K., Farmer, R., Burger, E. L., & Patel, V. V.
ORCID
Venue
Orthopedics
Publisher
SLACK, Inc.
Published
2015-09
Volume
38
Issue
9
Pages
e819-24
ISSN
  • 0147-7447 (ISSN-L)
  • 1938-2367
DOI
10.3928/01477447-20150902-61
OpenAlex
W2399992021
Cited by
13
References
22
Citations by year
2026: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 3
FWCI
3.04
Type
journal article
Language
en
Open access
closed
Locations
  • Orthopedics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
patient-controlled analgesia, transdermal fentanyl, intravenous morphine, postoperative pain, spinal surgery, application site reactions, adverse events, opioid analgesia
MeSH terms
Administration, Cutaneous, Analgesics, Opioid, Female, Fentanyl, Humans, Infusion Pumps, Infusions, Intravenous, Iontophoresis, Male, Middle Aged, Morphine, Pain Measurement, Postoperative Pain, Pain, Postoperative, Postoperative Care, Retrospective Studies, Spinal Diseases, Analgesia, Patient-Controlled, Treatment Outcome, Pain Management

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