ABSTRACT
<b>Introduction</b>: There has been no case report in which hyperpigmentation developed on the skin area where a transdermal fentanyl patch was applied in a patient. <b>Case report</b>: A 43-year-old man with recurrence of postoperative rectal cancer was treated by cetuximab plus irinotecan and panitumumab plus FOLFIRI. For cancer pain, transdermal fentanyl patch (Fentos®) was administered, and radiation from behind was performed. Hyperpigmentation then appeared on the chest and the abdominal skin sites where the patches were applied. The hyperpigmentation nearly disappeared four months after the fentanyl patch was discontinued. <b>Discussion</b>: The cause of the pigmentation was possibly due to post inflammatory hyperpigmentation secondary to contact dermatitis. It was desirable to conduct patch test and skin biopsy for making an accurate diagnosis. <b>Conclusion</b>: We should pay a careful attention to hyperpigmentation of the skin where a transdermal fentanyl patch is applied.
ABSTRACT
OBJECTIVE: To evaluate the therapeutic efficacy of transdermal fentanyl patches for moderate to severe cancer pain in aspects of pain control, quality of life, ADR, and etc. METHODS: Using the standard case report form combined with brief pain inventory (BPI) and numerical rating scale (NRS), 39 patients with moderate to severe cancer pain who received transdermal fentanyl (initial dose of 25 μg · h-1) for no less than five weeks were investigated. RESULTS: The total effective rate was 97.4% (38/39) and the average pain relief degree was 60.3%. All the patients gained significant improvement in multiple aspects of the quality of life. The main ADRs included constipation, dizziness, nausea, drowsiness, skin itch and etc, which were endurable, especially in the later therapeutic period. CONCLUSION: Transdermal fentanyl patches are the ideal alternative for patients with moderate to severe cancer pain. Copyright 2012 by the Chinese Pharmaceutical Association.
ABSTRACT
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 12.5microgram/hr, respectively. RESULTS: Two of 16 patients receiving a 25microgram/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 25microgram/hr TFP group (n=4 patients). Parameters of SO function also did not significantly change in the 12.5microgram/hr TFP group (n=11 patients). CONCLUSIONS: TFPs below a dose of 25microgram/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.
Subject(s)
Humans , Analgesics , Catheters , Dependency, Psychological , Fentanyl , Manometry , Pancreatitis , Prospective Studies , Sphincter of OddiABSTRACT
A 60-year-old man was diagnosed with locally advanced non-small cell lung cancer. He refused treatment with a curative aim and was treated conservatively. Pain had developed on his shoulder and chest wall, which became worse as the cancer progressed. Although his pain initially appeared to be relieved with weak opioids and analgesics, it became more severe Strong opioids (transdermal fentanly patch and oxycodone), antidepressant or epidural block were introduced, However, the background pain became more intense and reached up to 8~9/10 on the visual analog scale (VAS). The dose of the transdermal fentanl patch was gradually increased to 600?g/hr, which resulted in a dramatic improvement in his pain (9/10 of VAS) to 3/10 for most of the time. We described the successful experience with a high dose transdermal fentanyl patch for cancer pain relief, which might be an alternative option for cancer patients suffering from severe pain.
Subject(s)
Humans , Middle Aged , Analgesics , Analgesics, Opioid , Carcinoma, Non-Small-Cell Lung , Fentanyl , Lung Neoplasms , Lung , Shoulder , Thoracic Wall , Visual Analog ScaleABSTRACT
BACKGROUND: Postherpetic neuralgia is a persistant pain which occurs after the reactivation of varicella zoster infection. It sometimes disrupts the lives of otherwise healthy individuals. A transdermal patch of analgesics such as fentanyl could be a novel and safe method, with less adverse problems, to relieve the prolonged pain in postherpetic neuralgia. OBJECTIVE: The aim of this study was to evaluate the analgesic effect and safety of transdermal fentanyl patch in intractable postherpetic neuralgia. METHODS: We applied a fentanyl patch on the chest for 6 days, changing it once on the fourth day. The severity of pain was evaluated by visual analogue scale (VAS), and was assessed before treatment, the first and third day after commencement of treatment, and 1 day after treatment had finished. Any side effects were also checked at each VAS assessment session. RESULTS: The average VAS pain score of the pretreatment, first, third, and seventh day were as follows; 82.9+/-8.8, 49.6+/-15.8, 45.0+/-16.5, 45.7+/-15.2. Postherpetic neuralgia was dramatically improved from the first day of treatment, and the improved state was maintained until 1 day after the treatment had finished (p<0.05). Several side effects such as contact dermatitis (9.5%), mild nausea (14.3%), and constipation (9.5%) were observed during the treatment. CONCLUSION: Fentanyl patch is an effective, simple and relatively safe method in the treatment of intractable postherpetic neuralgia.