Abstract

LASTRA DEL PRADO, R. et al. Use of transdermic fentanyl by a department of home medical care of terminal oncologi patients. Oncología (Barc.) [online]. 2005, vol.28, n.10, pp.31-36. ISSN 0378-4835.

PURPOSE: An observational and retrospective study was performed in order to evaluate the activity and toxicity of transdermal fentanyl in patients with advanced cancer. MATERIAL AND METHODS: 112 patients treated by a home palliative care unit were studied. The characteristics of patients, analgesic treatments, and opioid rotation were analysed from the beginning of fentanyl administration to the death. RESULTS: The mean age of the patients (p) was 71.5 years (range, 29-88). The indication for opioid administration was pain in 102 and dyspnea in 10 patients. The type of pain was visceral in 56 p (55%), bony in 25 p (25%), neuropatic in 13 p (12.8%), muscular in 5 p (5%), and others in 3 p (2.1%). The baseline mean value of the pain analogical visual scale (AVS) was 5.9. The analgesics administered before fentanyl was given were tramadol (32.2%), NSAIDs (31%), morphine (31%) and codeine (5.6%). The median initial dose of fentanyl was 50 µg (range, 25-300). The final mean dose at the time of death was 75 µg (25-400). The final mean AVS was 3.3. The median treatment duration was 44 days (range, 1 to 372). It caused G2-3 nausea in 35 p (31%), somnolence in 13 p, and agitation in 5 p; 81 patients received laxatives. Opioid rotation with morphine was necessary in 10 p because of toxicity, and in 6 p because uncontrolled pain. CONCLUSIONS: Transdermal fentanyl is a well tolerated analgesic in patients with advanced cancer, providing a good analgesia in up to 91% of the patients previously treated with opioids, as well as of the patients proceeding directly from the first or second step of the WHO ladder.

Keywords : Transdermal fentanyl; Cancer pain; Palliative care.

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