TY - JOUR
T1 - Use of Intravenous Fentanyl Against Morphine Tolerance in Breakthrough Cancer Pain
T2 - A Case Series and Literature Review
AU - Hwang, In Cheol
AU - Bruera, Eduardo
AU - Park, Sang Min
PY - 2014/2
Y1 - 2014/2
N2 - Palliative care physicians are accustomed to using transdermal fentanyl patch for cancer pain control but not so familiar with its intravenous administration. Historically, fentanyl has been used to treat breakthrough pain because it is a very potent analgesic with a rapid onset and short duration of action. Although several formulations of fentanyl have been recently developed for breakthrough cancer pain, these are unavailable or too expensive in some countries. Also, all opioids can induce tolerance potentially and different opioids cause significantly different degrees of tolerance. Therefore, sequential opioid trials may be a reasonable approach in patients with poor analgesic effect after dose escalation. Here, we present 2 morphine-tolerant patients with cancer in whom the intravenous fentanyl was effectively used for their refractory breakthrough pain.
AB - Palliative care physicians are accustomed to using transdermal fentanyl patch for cancer pain control but not so familiar with its intravenous administration. Historically, fentanyl has been used to treat breakthrough pain because it is a very potent analgesic with a rapid onset and short duration of action. Although several formulations of fentanyl have been recently developed for breakthrough cancer pain, these are unavailable or too expensive in some countries. Also, all opioids can induce tolerance potentially and different opioids cause significantly different degrees of tolerance. Therefore, sequential opioid trials may be a reasonable approach in patients with poor analgesic effect after dose escalation. Here, we present 2 morphine-tolerant patients with cancer in whom the intravenous fentanyl was effectively used for their refractory breakthrough pain.
KW - breakthrough cancer pain
KW - intravenous fentanyl
KW - morphine tolerance
UR - http://www.scopus.com/inward/record.url?scp=84893177635&partnerID=8YFLogxK
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U2 - 10.1177/1049909112474112
DO - 10.1177/1049909112474112
M3 - Article
C2 - 23345613
AN - SCOPUS:84893177635
SN - 1049-9091
VL - 31
SP - 109
EP - 111
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 1
ER -