[Postoperative pain management. Application of an iontophoretic patient-activated transdermal system]

Intravenous patient-controlled analgesia (i.v. PCA) for parenteral postoperative pain control is considered standard therapy as patients can individually titrate the amount of analgesic as needed. Iontophoretic patient-activated transdermal systems (IPATS) are a new non-invasive pre-programmed method for postoperative pain control. By pressing the dosing button a 40 microg dose of fentanyl is delivered over a 10 min period via iontophoresis through the intact skin. Several comparative randomized controlled trials have demonstrated that IPATS provide postoperative pain control equivalent to i.v. PCA with morphine. Thus, IPATS is a new method in the management of acute postoperative pain which increases patient mobility and reduces time and effort of care as well as the risk of programming errors. In this review the efficacy, pharmacokinetics, handling and process cost-effectiveness of IPATS are discussed.