Patient-controlled analgesia transdermal

Sinatra, R. (2005), The fentanyl FI Cl patient-controlled transdermal system (PCTS) An alternative to intravenous patient-controlled analgesia in the postoperative setting, Clin. Pharmacokinet., 44(Suppl 1), 1-6. 

The efficacy and safety of a fentanyl ionto-phoretic transdermal system have been explored in a meta-analysis of six trials [72 ]. In comparisons of the fentanyl transdermal system and morphine in patient-controlled analgesia, fewer of those who received fentanyl withdrew because of adverse effects, fewer had nausea and pruritus, and none had respiratory depression however, more had headaches. 

Patient controlled transdermal analgesia (PCTA) is one of the newest variations on PCA. PCTA uses a delivery system consisting of a small patch that is approximately the size of a credit card.29,45 This patch is adhered to the patient s skin, usually on the arm or upper chest. The patch is impregnated with an opioid such as fentanyl, and the patient can self-administer a... 

ChellyJE, Grass J, Houseman TWj et al. The safety and efficacy of a fentanyl patient-controlled transdermal system for acute postoperative analgesia a multicenter, placebo-controlled trial. Anesth Analg. 2004 98 427M33. 

The more novel routes of administration of opioids, including oral, nasal, rectal, transdermal, spinal, and by patient-controlled methods, have been outlined (SEDA-17, 78). Oral transmucosal fentanyl administration, avoiding first-pass metabolism, produces analgesia and sedation in both adults and children undergoing short, painful outpatient procedures. The quality of analgesia is good, and the adverse effects are those typical of the opioids. 

Iontophoretic transdermal fentanyl (fentanyl ITS) was FDA-approved for short-term management of acute post-operative pain in hospitalized adults. The system is intended to be a patient-controlled method for maintenance of analgesia. Titration of a loading dose with opioids to an acceptable analgesic level prior to initiation of the system is recommended. Moreover, since the current (and hence the dose) are not adjustable, this system is most appropriate for opioid-naive patients and should not be preferred for opioid-tolerant subjects or those requiring a basal infusion. 

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