Tolerance of Fentanyl Pectin Nasal Spray for Procedural Pain in Geriatric Patients.
J Am Med Dir Assoc
; 23(6): 1005-1010, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-35398051
ABSTRACT
OBJECTIVES:
We aimed to assess the tolerance of fentanyl pectin nasal spray (FPNS) when used to treat procedural pain caused by wound dressing or physiotherapy in patients older than 75 years with or without opioid background treatment.DESIGN:
This is a prospective monocentric, noncontrolled, nonrandomized study conducted from December 2014 to October 2017 in 2 geriatric wards (rehabilitation and acute medicine). SETTING ANDPARTICIPANTS:
Fifty-seven patients were included and 314 procedures were monitored.METHODS:
For each patient, 6 procedures were monitored the first 2 without specific treatment, then fentanyl was started at 100 µg with a titration over a few procedures up to 800 µg in non-opioid-naïve patients and 400 µg in opioid-naïve. Sedation and respiratory scale were monitored during the procedures. All adverse drug events occurring from inclusion to 5 days after the intervention were collected and their imputability was assessed separately by 2 pharmacovigilance experts.RESULTS:
Overall, 14.4% of the sessions with FPNS administration resulted in adverse drug events. Main adverse drug events were nausea and vomiting, somnolence, and confusion. Most of them were of mild to moderate severity. Four severe adverse events were due to accidental overdoses. No unexpected adverse event occurred. Tolerance was similar for opioid-naïve and non-opioid-naïve patients (P value = .93). CONCLUSION AND IMPLICATIONS FPNS was overall well tolerated in geriatric patients. Given its interesting pharmacokinetics, fentanyl is a promising lead for procedural pain treatment in geriatric patients, even those who are opioid naïve.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
/
Dor Processual
/
Neoplasias
Tipo de estudo:
Observational_studies
Limite:
Aged
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Humans
Idioma:
En
Revista:
J Am Med Dir Assoc
Assunto da revista:
HISTORIA DA MEDICINA
/
MEDICINA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França