Trans-Dermal Fentanyl Patches are a Cost-Effective Method of Long-Term Analgesic Delivery Following Corneal Exposure to Sulfur Mustard Vapor

Analgesic pain management for acute pain resulting from ocular sulfur mustard (SM) exposure in rabbits involves delivery of the opioid receptor agonist buprenorphine using subcutaneously implanted osmotic pumps. The combination of an invasive surgery, risk of postsurgical infection and central effects makes this system suboptimal. Alternatively, fentanyl, a synthetic opioid with predominantly mu receptor agonist activity, is significantly more potent than buprenorphine, with fewer associated CNS side effects. Fentanyl is commercially available as a transdermal patch (Duragesic ), obviating the need for surgery and the risks of secondary complications. To evaluate fentanyl transdermal patches (FPs) as a novel analgesic delivery system for the acute pain associated with ocular SM exposures in rabbits, we studied the analgesic efficacy, conducted resource cost-comparisons and assessed the ease of use and compatibility of FPs with experimental protocols. We found that FP use resulted in decreased symptoms of rabbit pain and distress, reduced experimental duration by 39%, reduced personnel requirements by 14%, and lowered total experimental costs by 43%, or over $8,400 per each 16-rabbit exposure. These data suggest that FPs provide efficient, cost-effective and humane analgesia following ocular SM exposure, while eradicating the discomfort, distress and risk associated with implantation and removal of osmotic pumps. The original document contains color images.