Abstract

VIDAL, M.A.; TRINIDAD, J.M.  and  TORRES, L.M.. Intranasal fentanyl in the treatment of oncological pain. Rev. Soc. Esp. Dolor [online]. 2014, vol.21, n.2, pp.106-111. ISSN 1134-8046.  https://dx.doi.org/10.4321/S1134-80462014000200008.

Breakthrough oncological pain (BOP) consists of a transient exacerbation on a persistent otherwise basal controlled pain. It is a moderate or severe pain that reaches the peak of intensity quickly and has a relatively short duration. These features make fentanyl a good treatment option due its high lipophilicity and quick absorption. Here takes on special importance the intranasally route which, by its high vascularization and permeability, constitutes a particularly quick route. Recently, fentanyl mixed with a solution of pectin called PecFent^® nasal spray has been developed. The objective of this study is to conduct a review of published studies on its use for the treatment of BOP. Randomized, controlled, double-blind trials have shown an onset of the pain relief in just 5 minutes after its administration, as well as in 10 min clinically meaningful pain relief. Despite being the current standard treatment of immediate release morphine sulfate, comparative studies have shown the superiority of intranasal fentanyl to treat this type of episodes. Intranasal fentanyl achieves a faster than other drugs and clinically meaningful pain relief. The administration by intranasal fentanyl has proven to be well tolerated. Clinical trials program is has found the presence of typical adverse effects of the drugs opioid in this population. The most common were vomiting, nausea, progression of the disease and constipation, the majority being mild to moderate in intensity. The nasal route did not damage by continued use of intranasal fentanyl.

Keywords : Intranasal fentanyl; Breakthrough oncological pain; Cancer; Efficiency; Tolerance.

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