Oral transmucosal fentanyl citrate versus placebo for painful dressing changes: a crossover trial.

Author(s): MacIntyre PA, Margetts L, Larsen D, Barker L

Affiliation(s): Royal Devon and Exeter Hospital, Exeter, UK. jamac@doctors.org.uk

Publication date & source: 2007-03, J Wound Care., 16(3):118-21.

Publication type: Randomized Controlled Trial

OBJECTIVE: Fentanyl is a potent opioid that is well absorbed via the oral mucosa. It can be given as an oral lozenge. The onset of analgesia is rapid and matches the pain profile observed at dressing changes. METHOD: Patients experiencing pain during daily dressing changes were given entonox plus either placebo or oral transmucosal fentanyl citrate (OTFC) for two consecutive dressing changes in a randomised double-blind placebo-controlled crossover trial. RESULTS: Nine patients were recruited. The mean worst pain score during dressing changes was 7/10 with placebo and 4/10 with OTFC; the reduction in pain achieved with OTFC was significant. The mean number of breaths of entonox taken during the dressing change was 27.67 with placebo and 4.67 with OTFC; the reduction in the number of entonox breaths with OTFC was significant. One patient in the OTFC group suffered nausea. CONCLUSION: Compared with placebo, OTFC improved analgesia during painful dressing changes without an increase in side-effects.