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The efficacy of transdermal fentanyl for pain relief after endoscopic submucosal dissection: a prospective,
Hyuk Soon Choi1, Kyoung-Oh Kim, Hoon Jai Chun
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Objective:
Epigastric pain management following endoscopic submucosal dissection is an important consideration. This study aimed to investigate the utility and safety of fentanyl patches for pain relief after the procedure.
Methods:
Patients who were scheduled to undergo endoscopic submucosal dissection were prospectively randomised to either a transdermal fentanyl patch group or a placebo control group. An additional pethidine was intravenously administered when pain developed and a numerical rating scale was used to evaluate both pre- and post-procedural pain.
Results:
One hundred and ten patients were randomly assigned to receive either a 12 mcg/h fentanyl patch or a control patch on the night before the procedure. The fentanyl patch group had significantly lower pain scores immediately following the procedure (mean, 5.17 vs. 4.26, p=0.030). Maximal pain scores during the first 24 h (5.43 vs. 4.46, p=0.038) and pain scores on the day after the procedure (2.98 vs. 1.20, p<0.001) were also lower in the fentanyl patch group. In addition, the fentanyl patch group required a significantly lower dose of pethidine for pain management (24.54 vs. 11.25, p=0.004).
Conclusions:
The application of a transdermal fentanyl patch is an effective, convenient, and safe method to control epigastric pain after endoscopic submucosal dissection.