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Pain and Chemical Dependency News
Fentanyl is commonly used systemically or neuraxially to manage chronic pain.
It can be administered via implanted pump but is generally considered only when
intrathecal (IT) morphine and hydromorphone have not been effective. There is
limited published experience with IT fentanyl, and long-term therapy at relatively
high doses has not been described previously.
The investigators describe four patients who were treated with IT fentanyl
after other analgesic approaches had failed and who gradually underwent dose
escalation to levels as high as 20 times those previously reported. Safety and
tolerability were maintained during dose titration. They report that this experience
highlights an expanding scope of practice in the use of IT opioids in general
and fentanyl specifically and suggest that high-dose fentanyl can be used safely
in highly selected patients. Do Ouro S, Esteban S, Sibirceva U, Whittenberg
B, Portenoy R, Cruciani RA. Adapted from J Opioid Manag. 2006 Nov-Dec;2(6):365-8.
PMID: 17326599
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the
National Library of Medicine (NLM).
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