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Striebel HW, Schwagmeier R, Boerger N. Neue Applikationswege für Opioide. [New modes of opioid administration.]. Schmerz. 1993;7(3):131-9doi: 10.1007/BF02530420.
Striebel, H. W., Schwagmeier, R., & Boerger, N. (1993). Neue Applikationswege für Opioide. [New modes of opioid administration.]. Schmerz (Berlin, Germany), 7(3), 131-9. https://doi.org/10.1007/BF02530420
Striebel, H W, et al. "Neue Applikationswege für Opioide." [New modes of opioid administration.]. Schmerz (Berlin, Germany) vol. 7,3 (1993): 131-9. doi: https://doi.org/10.1007/BF02530420
Striebel HW, Schwagmeier R, Boerger N. Neue Applikationswege für Opioide. [New modes of opioid administration.]. Schmerz. 1993 Sep;7(3):131-9. doi: 10.1007/BF02530420. German. PMID: 18415398.
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Schmerz. 1993 Sep;7(3):131-9. doi: 10.1007/BF02530420.

[New modes of opioid administration.].

Schmerz (Berlin, Germany)

[Article in German]
H W Striebel, R Schwagmeier, N Boerger

Affiliations

  1. Klinik für Anästhesiologie und operative Intensivmedizin Klinikum Steglitz Freie Universität Berlin, Hindenburgdamm 30, 12203, Berlin.

PMID: 18415398 DOI: 10.1007/BF02530420

Abstract

In the last few years great interest has developed in new modes of opioid administration; oral transmucosal, transdermal, peripheral, and nasal administration.Oral transmucosal administration of fentanyl citrate (OTFC) has most often been used for premedication in children. Meanwhile, studies on the use of OTFC in cancer patients for postoperative pain management have also been published. While OTFC may have a limited role in postoperative pain management, it may prove very helpful in the management of incident and breakthrough cancer pain. Patient acceptance is high, and the onset of action is relatively rapid.Transdermal administration of fentanyl (TTS fentanyl) has been extensively examined, especially in postoperative patients. Patient acceptance is high, and TTS-fentanyl-related side-effects (e.g. mild erythema at the site of application) are minor. Application is performed at 72-h intervals. Kinetics are stable with repeated dosing, and serum concentrations approach steady state with the first dose. The slow rise/decline in fentanyl plasma concentration with patch application/removal makes it less well suited for postoperative pain management. However, TTS fentanyl seems to be a promising mode of opioid administration for cancer patients.-Recent papers have unequivocally demonstrated a peripheral antinociceptive effect oflocally applied opioids, especially in inflamed tissue. However, the results of clinical investigations are equivocal so far: about half the reports demonstrate an analgesic effect of peripherally administered opioids, and the other half, not.Intranasal administration was introduced for premedication in children, but benzodiazepines seem to be the better and safer choice. Nonetheless, intranasal opioids guarantee a rapid rise in opioid plasma concentrations as well as a rapid onset of pain relief. This mode of administration seems to be especially suitable for the treatment of acute pain syndromes, such as breakthrough cancer pain or incident pain. Patient acceptance is high, and no local problems were reported.

References

  1. Anesth Analg. 1983 Feb;62(2):164-7 - PubMed
  2. Eur J Pharmacol. 1984 Mar 16;99(1):23-9 - PubMed
  3. Anesth Analg. 1993 Feb;76(2):377-81 - PubMed
  4. Pain. 1990 Jun;41(3):273-281 - PubMed
  5. Anesthesiology. 1989 Sep;71(3):374-7 - PubMed
  6. Reg Anesth. 1990 Jul-Aug;15(4):186-93 - PubMed
  7. J Pharmacol Exp Ther. 1989 Mar;248(3):1269-75 - PubMed
  8. N Engl J Med. 1991 Oct 17;325(16):1123-6 - PubMed
  9. Anesth Analg. 1993 Jan;76(1):182-91 - PubMed
  10. Anaesthesia. 1988 Apr;43(4):270-3 - PubMed
  11. Anesthesiology. 1993 Jan;78(1):36-43 - PubMed
  12. Anaesthesia. 1991 Dec;46(12):1074-6 - PubMed
  13. Schmerz. 1990 Jun;4(2):65-74 - PubMed
  14. Anesthesiology. 1991 Jan;74(1):28-33 - PubMed
  15. Clin Pharmacol Ther. 1988 Sep;44(3):335-42 - PubMed
  16. Br J Clin Pharmacol. 1982 May;13(5):665-73 - PubMed
  17. Anesthesiology. 1989 Apr;70(4):616-21 - PubMed
  18. Anesthesiology. 1989 Jun;70(6):928-34 - PubMed
  19. Nature. 1980 Mar 27;284(5754):351-3 - PubMed
  20. Neurosci Lett. 1988 Jan 22;84(2):225-8 - PubMed
  21. J Pharmacol Exp Ther. 1987 Jan;240(1):159-66 - PubMed
  22. Life Sci. 1982 Sep 20-27;31(12-13):1205-8 - PubMed
  23. Anesthesiology. 1985 Mar;62(3):234-41 - PubMed
  24. Anesthesiology. 1992 Sep;77(3):463-6 - PubMed
  25. Anaesthesia. 1991 Mar;46(3):167-8 - PubMed
  26. Anesth Analg. 1987 Dec;66(12):1277-81 - PubMed
  27. Anesthesiology. 1992 Feb;76(2):209-15 - PubMed
  28. Anesth Analg. 1985 Jul;64(7):667-71 - PubMed
  29. Anesthesiology. 1992 Aug;77(2):281-5 - PubMed
  30. Reg Anesth. 1989 Nov-Dec;14(6):274-8 - PubMed
  31. Anaesthesia. 1991 Apr;46(4):278-80 - PubMed
  32. Anaesthesist. 1987 Aug;36(8):400-6 - PubMed
  33. Schmerz. 1993 Mar;7(1):4-7 - PubMed
  34. Pain. 1990 Aug;42(2):215-225 - PubMed
  35. Can J Anaesth. 1989 Sep;36(5):494-7 - PubMed
  36. Pain. 1991 May;45(2):149-153 - PubMed
  37. Anesth Analg. 1989 Sep;69(3):328-35 - PubMed
  38. Anesth Analg. 1989 Jul;69(1):28-34 - PubMed
  39. Reg Anesth. 1992 Jul-Aug;17(4):223-7 - PubMed
  40. Br J Anaesth. 1988 May;60(6):614-8 - PubMed
  41. Anesth Analg. 1987 May;66(5):417-20 - PubMed
  42. Can J Anaesth. 1990 Nov;37(8):857-66 - PubMed
  43. Anaesthesist. 1983 Apr;32(4):165-73 - PubMed
  44. Anesthesiology. 1989 Oct;71(4):615-7 - PubMed
  45. Br J Anaesth. 1989 Jul;63(1):56-9 - PubMed
  46. Acta Anaesthesiol Scand. 1991 Jan;35(1):14-8 - PubMed
  47. Br J Anaesth. 1988 May;60(6):608-13 - PubMed
  48. Anesthesiology. 1992 Aug;77(2):263-6 - PubMed
  49. Anesthesiology. 1988 May;68(5):671-5 - PubMed
  50. Schmerz. 1988 Mar;2(1):38-41 - PubMed
  51. Pain. 1989 Apr;37(1):15-21 - PubMed
  52. Anesthesiology. 1991 Jan;74(1):53-63 - PubMed
  53. Br J Anaesth. 1992 Dec;69(6):637-9 - PubMed
  54. Anesth Analg. 1989 Jul;69(1):21-7 - PubMed

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