Background: Three transmucosal fentanyl products have recently been licensed for cancer-related breakthrough pain: a sublingual tablet, a buccal/sublingual tablet and a nasal spray. Limited comparative data hinder identifying the most appropriate to use and adopt onto a service formulary. However, the availability of placebo formulations provides a unique opportunity to compare the practical aspects of their use.
Methods: 30 patients with cancer accessed and administered a placebo of each product and were asked to rate them using 1-7 Likert agree-disagree scales and free-text responses, with regard to ease of access and administration, palatability and overall impression. Participants rated their usual rescue analgesic similarly, based on recall. They also indicated whether they would be prepared to use the fentanyl product, and their most preferred.
Results: For accessibility, the usual rescue analgesic was rated best (median score 3), significantly better than the buccal/sublingual tablet (p=0.01) and nasal spray (p<0.01), but not the sublingual tablet. Conversely, the nasal spray was rated significantly worse (median score 7) than the others (p<0.01). For ease of administration, the usual rescue analgesic and sublingual tablet were rated equally best (median score 1), with only the latter being significantly different to the buccal/sublingual tablet (p=0.04) and nasal spray (p=0.05). For palatability, the sublingual tablet was rated the best (median score 2), but was significantly different only to the buccal/sublingual tablet (p<0.01). For overall impression, the sublingual tablet was rated significantly better (median score 3) than the others, with more patients prepared to use it and selecting it as their most preferred (27 and 18, respectively).
Conclusion: This survey provides valuable insight into the practical aspects of these three transmucosal fentanyl products for practitioners considering their use.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/bmjspcare-2011-000037 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Fentanyl Hapten-Displaying Lipid Nanoparticle Vaccine that Non-Covalently Encapsulates a TLR7/8 Agonist and T-Helper Epitope Induces Protective Anti-Fentanyl Immunity.
Angew Chem Int Ed Engl
October 2024
Department of Pharmaceutics, Ghent University, Belgium, Ottergemsesteenweg 460, Gent, 9000, Belgium.
Opioid use disorder - particularly involving fentanyl - has precipitated a public health crisis characterized by a significant increase in addiction and overdose-related deaths. Fentanyl-specific immunotherapy, which aims at inducing fentanyl-specific antibodies capable of binding fentanyl molecules in the bloodstream, preventing their entry in the central nervous system, is therefore gaining momentum. Conventional opioid designs rely on the covalent conjugation of fentanyl analogues to immunogenic carrier proteins that hold the inherent capacity of mounting immunodominant responses.
View Article and Find Full Text PDFEvaluation of Intranasal Fentanyl and Midazolam Among Inpatient Pediatric Patients.
Hosp Pediatr
October 2024
Internal Medicine and Pediatrics.
Article Synopsis
- A study looked at how safe and helpful it is to use nose sprays of certain medicines, fentanyl and midazolam, for kids in hospitals.
- The study found that most kids received midazolam, and these medicines were often used when kids had to go through procedures like getting an IV or a lumbar puncture.
- No serious side effects were reported, but the researchers say more studies should be done before using these medicines more widely in hospitals.
Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department.
BMJ Paediatr Open
September 2024
Pediatric Palliative Care Service, Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy.
Background: Despite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes.
Methods: A multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group.
Intranasal Fentanyl Versus Morphine in Fracture Reduction in a Pediatric Trauma Center.
J Am Acad Orthop Surg
December 2024
From the Emergency Department, Paris Saint-Joseph Hospital Group (Bisso), the Paediatric Emergency Department, AP-HP, Robert Debre Hospital University, Paris University (Tielli), and the Paediatric Emergency Department, AP-HP, Necker-Enfants-Malades University Hospital, Paris University, Paris, France (Lopes).
Purpose: Pain management in orthopaedic manipulation in the emergency department (ED) is crucial to decrease fracture reduction performed in the operating room. This study compared intranasal fentanyl (INF) with oral morphine in time of care and effectiveness on pain during the reduction of bone fractures in a pediatric trauma center.
Methods: A before-and-after INF implementation study was conducted in a pediatric ED with a trauma center on children with a confirmed displaced closed fracture on radiographs with reduction and casting performed in the ED.
The use of intranasal sufentanil and/or s-ketamine for treatment of procedural pain in children in an ambulatory setting: A retrospective observational study.
Acta Anaesthesiol Scand
November 2024
Pain Treatment Service, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Background: Minor but painful medical procedures are often handled at the operating room. If safe and effective treatment options are available many procedures may be performed outside of the operating room.
Objective(s): The objective of this study is to assess the adverse events of intranasal s-ketamine and/or sufentanil alone or as part of a multimodal analgesic regime for medical procedures outside of the operating room.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!