PMID: 9533063Apr 9, 1998Paper

Continuous fentanyl infusion: use in severe cancer pain

The Annals of Pharmacotherapy
K L Lenz, D S Dunlap

Abstract

To describe the use of a continuous fentanyl infusion in an adult cancer patient. A 66-year-old white woman diagnosed with metastatic pancreatic carcinoma required hospital admission for pain control after receiving five different chemotherapy regimens. Morphine 2 mg/h i.v. was initiated and the dosage was titrated upward to a total of 6613 mg/d by hospital day 16. As hospital supplies of opioids became depleted over a holiday weekend, therapy was changed to a continuous infusion of hydromorphone 70 mg/h on hospital day 17, then changed to a continuous fentanyl infusion beginning with a dosage of 500 micrograms/h. The fentanyl dosage was titrated to 4250 micrograms/h by hospital day 20. She died comfortably on hospital day 22 while receiving this dosage. Continuous infusions of opioids, particularly morphine and hydromorphone, are frequently used for control of cancer pain and are safe and effective when administered by this route. Transdermal fentanyl has been shown to effectively manage chronic cancer pain, and use of continuous subcutaneous fentanyl has been reported. However, reports of continuous intravenous fentanyl infusion in the cancer pain literature are limited. Our patient achieved good pain control with a continuou...Continue Reading

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Citations

Nov 30, 2000·Critical Care : the Official Journal of the Critical Care Forum·D Crippen
Aug 5, 2000·Annales de chirurgie·D Francon, M Giovannini
Jan 25, 2013·The American Journal of Hospice & Palliative Care·In Cheol HwangSang Min Park
Jun 16, 2001·The American Journal of Hospice & Palliative Care·J M BergerP Harrison

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