Research Progress of Fentanyl

Area of Science:

• Pharmacology
• Pain Management
• Drug Delivery Systems

Background:

• Fentanyl, a potent μ receptor agonist, is vital for perioperative and cancer pain management.
• Risks of respiratory depression and abuse pose global public health challenges.
• Novel drug delivery systems enhance fentanyl utility but necessitate balancing benefits with safety.

Purpose of the Study:

• To review current evidence on fentanyl pharmacology and clinical applications.
• To focus on multimodal administration, dose adjustment for special populations, and anti-abuse strategies.
• To synthesize information on regulatory policies impacting fentanyl use.

Main Methods:

• Systematic literature search (PubMed, Embase, CNKI) from database inception to September 2025.
• Inclusion of randomized controlled trials, meta-analyses, reviews, and clinical guidelines.
• Search terms: 'fentanyl', 'analgesia', 'pharmacokinetics', 'respiratory depression', 'abuse prevention'.

Main Results:

• Fentanyl's μ-receptor binding and pharmacokinetics drive rapid, potent analgesia.
• Intravenous administration offers rapid relief; mucosal routes provide sustained exposure.
• Dose reduction is critical for elderly and hepatic impairment patients; anti-abuse measures are vital.

Conclusions:

• Effective fentanyl use demands integrated strategies: pharmacology, patient factors, and regulation.
• A proposed clinical pathway optimizes analgesia and minimizes adverse outcomes.
• Future research should focus on Chinese population guidelines and genomic predictors for personalized pain management.