Effect of Transdermal Fentanyl Patches on the Motility of the Sphincter of Oddi

Background/Aims: Pain is one of the most troublesome symptoms of pancreatitis. Transdermal fentanyl patches (TFPs) are long-acting analgesics with a reduced risk of dependency. This prospective study evaluated the effect of TFPs on sphincter of Oddi (SO) motility for the management of pain in pancreatitis. Methods: SO manometry (SOM) was performed using triple-lumen catheters anterogradely inserted through the percutaneous transhepatic route during cholangioscopy in 16 patients. The basal pressure, amplitude, and frequency of the SO were assessed before and after applying a TFP at 24 hour at doses of 25 and 12.5μg/hr, respectively. Results: Two of 16 patients receiving a 25μg/hr. TFP were excluded because of adverse side effects (headache and/or nausea). The mean basal pressure, amplitude, and frequency of SOM did not change significantly in the 25μg/hr TFP group (n=4 patients). Parameters of SO function also did not significantly change in the 12.5μg/hr TFP group (n=11 patients). Conclusions: TFPs below a dose of 25μg/hr may not affect the motility of the SO. Administration of TFPs at lower dosages seems to be a safe analgesic treatment for the pain control of patients with pancreatitis without affecting the function of the SO. (Gut Liver 2010;4: 368-372)