Intravenous fentanyl for cancer pain:
a "fast titration" protocol for the emergency room
by
Soares LG, Martins M, Uchoa R.
Centro de Suporte Terapeutico Oncologico,
Instituto Nacional de Cancer,
Rue Marques de Pinedo 97/402,
Laranjeiras 22231100,
Rio de Janeiro, Brazil.
Pain Symptom Manage. 2003 Sep;26(3):876-81

ABSTRACT

Patients with cancer sometimes are admitted to the emergency room due to severe pain. Despite the fact that morphine's hydrophilicity can delay its peak effects after intravenous administration up to 30 minutes, it is still the most commonly used opioid during cancer pain emergencies. Fentanyl is a synthetic, lipophilic opioid, more potent than morphine, and achieves peak effects after intravenous administration in 5 minutes. According to our observations, intravenous fentanyl could be safely used in the emergency room to treat patients who need fast titration of an opioid to control their pain. In our study, fentanyl was employed in a four-step protocol to treat patients admitted to our palliative care emergency room due to severe pain, regardless of the previous use of morphine at home. Titration with intravenous fentanyl was successfully employed in 18/18 (100%) of patients, with an average time for pain control at about 11 minutes, and without relevant adverse effects. We conclude that intravenous fentanyl could be safely used for severe cancer pain when rapid titration is being considered.

Duragesic
Fentanyl analogs
4-methyl fentanyl
Driving on fentanyl
Fentanyl: synthesis
Transdermal fentanyl
Push-button fentanyl
Fentanyl and serotonin
Fentanyl and ketamine
Remifentanil and alfentanil
Fentanyl: subjective effects
Fentanyl and the immune system
From codeine to transdermal fentanyl
Fentanyl (Sublimaze, Duragesic) : structure

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