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PETER J. S. KOO, PHARM.D., is Associate Clinical Professor of Pharmacy and Pharmacist Specialist, Pain Management, Department of Clinical Pharmacy and Pharmaceutical Services, School of Pharmacy, University of California, San Francisco, C-152, Box 062, 521 Parnassus Avenue, San Francisco, CA 94143-0622 (pjkoo{at}value.net).

Purpose. The efficacy and safety of fentanyl hydrochloride patient-controlled trans-dermal system (PCTS) for management of acute postoperative pain are discussed. Summary. Fentanyl hydrochloride PCTS is a self-contained, needle-free, credit-card-sized fentanyl-delivery system that is worn on the patient’s arm or chest. The system uses iontophoretic technology to actively deliver preprogrammed doses of fentanyl into the systemic circulation when activated by the patient on demand. PCTS is as safe and effective as i.v. morphine patient-controlled analgesia and superior to placebo for managing acute postoperative pain. Fentanyl absorption from PCTS is clinically insignificant when the device is not activated. This contrasts with the transdermal fentanyl patch, which delivers fentanyl continuously for 72 hours via passive absorption and is indicated only for use in the management of chronic pain. Conclusion. Fentanyl hydrochloride PCTS is a self-contained iontophoretic fentanyl-delivery system that provides patients control over pain management and consistent management of pain without analgesic peaks and troughs. Index terms: Absorption; Fentanyl hydrochloride; Iontophoresis; Opiates; Pain; Patient-controlled analgesia; Surgery; Toxicity

 

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