Intravenous fentanyl for cancer pain: a “fast titration” protocol for the emergency room
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...
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| Veröffentlicht in: | Journal of pain and symptom management 2003-09, Vol.26 (3), p.876-881 |
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| container_end_page | 881 |
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| container_title | Journal of pain and symptom management |
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| creator | Soares, Luiz Guilherme L Martins, Maurı́lio Uchoa, Rudy |
| description | 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%) 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. |
| doi_str_mv | 10.1016/S0885-3924(03)00314-2 |
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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%) 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.</description><identifier>ISSN: 0885-3924</identifier><identifier>EISSN: 1873-6513</identifier><identifier>DOI: 10.1016/S0885-3924(03)00314-2</identifier><identifier>PMID: 14528871</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Analgesics ; Analgesics, Opioid - administration & dosage ; Biological and medical sciences ; Emergency Medical Services ; emergency room ; Fentanyl - administration & dosage ; Humans ; Injections, Intravenous ; intravenous fentanyl ; Medical sciences ; Middle Aged ; Neoplasms - complications ; Neuropharmacology ; Pain - drug therapy ; Pain - etiology ; Palliative Care - methods ; Pharmacology. 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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%) 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Analgesics</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Emergency Medical Services</subject><subject>emergency room</subject><subject>Fentanyl - administration & dosage</subject><subject>Humans</subject><subject>Injections, Intravenous</subject><subject>intravenous fentanyl</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasms - complications</subject><subject>Neuropharmacology</subject><subject>Pain - drug therapy</subject><subject>Pain - etiology</subject><subject>Palliative Care - methods</subject><subject>Pharmacology. Drug treatments</subject><subject>Severe cancer pain</subject><subject>Time Factors</subject><subject>titration</subject><subject>Titrimetry</subject><issn>0885-3924</issn><issn>1873-6513</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1uFDEQRi0EIpPAEUDegMKiocputzvZIBTxEykSC2CHZBl3GYy67cH2RJpdDgKXy0lwMiOyZFWb91V99Rh7gvASAYdXn2AcVSdPRH8M8gWAxL4T99gKRy27QaG8z1b_kAN2WMpPAFBykA_ZAfZKjKPGFft6Hmu2lxTTpnBPsdq4nblPmTsbHWW-tiGecsuvr357WyqvofE1pHh99Yevc6rJpV2g_iBOC-XvFN2W55SWR-yBt3Ohx_t5xL68e_v57EN38fH9-dmbi84pHGonVA_Wk_MaB01O-En60WqhQFhJErVyoE7QC7TKaz2NOMKgte4JUIKW8og93-1tfX5tqFSzhOJonm2k9pfRSve91NBAtQNdTqVk8madw2Lz1iCYG63mVqu5cWZAmlutRrTc0_2BzbeFprvU3mMDnu0BW5ydfW7yQrnjFCqlUTfu9Y6jpuMyUDbFheaLppDJVTOl8J8qfwGZ45Wk</recordid><startdate>20030901</startdate><enddate>20030901</enddate><creator>Soares, Luiz Guilherme L</creator><creator>Martins, Maurı́lio</creator><creator>Uchoa, Rudy</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030901</creationdate><title>Intravenous fentanyl for cancer pain: a “fast titration” protocol for the emergency room</title><author>Soares, Luiz Guilherme L ; Martins, Maurı́lio ; Uchoa, Rudy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-2540afecf7167ec2fd3f8a72502a3e3175c0591f21a5f77d818067774e0130733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analgesics</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Emergency Medical Services</topic><topic>emergency room</topic><topic>Fentanyl - administration & dosage</topic><topic>Humans</topic><topic>Injections, Intravenous</topic><topic>intravenous fentanyl</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasms - complications</topic><topic>Neuropharmacology</topic><topic>Pain - drug therapy</topic><topic>Pain - etiology</topic><topic>Palliative Care - methods</topic><topic>Pharmacology. Drug treatments</topic><topic>Severe cancer pain</topic><topic>Time Factors</topic><topic>titration</topic><topic>Titrimetry</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soares, Luiz Guilherme L</creatorcontrib><creatorcontrib>Martins, Maurı́lio</creatorcontrib><creatorcontrib>Uchoa, Rudy</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pain and symptom management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soares, Luiz Guilherme L</au><au>Martins, Maurı́lio</au><au>Uchoa, Rudy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous fentanyl for cancer pain: a “fast titration” protocol for the emergency room</atitle><jtitle>Journal of pain and symptom management</jtitle><addtitle>J Pain Symptom Manage</addtitle><date>2003-09-01</date><risdate>2003</risdate><volume>26</volume><issue>3</issue><spage>876</spage><epage>881</epage><pages>876-881</pages><issn>0885-3924</issn><eissn>1873-6513</eissn><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%) patients, with an average time for pain control at about 11 minutes, and without relevant adverse effects. 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| ispartof | Journal of pain and symptom management, 2003-09, Vol.26 (3), p.876-881 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Aged Analgesics Analgesics, Opioid - administration & dosage Biological and medical sciences Emergency Medical Services emergency room Fentanyl - administration & dosage Humans Injections, Intravenous intravenous fentanyl Medical sciences Middle Aged Neoplasms - complications Neuropharmacology Pain - drug therapy Pain - etiology Palliative Care - methods Pharmacology. Drug treatments Severe cancer pain Time Factors titration Titrimetry |
| title | Intravenous fentanyl for cancer pain: a “fast titration” protocol for the emergency room |
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