Transbuccal fentanyl for rapid relief of orthopedic pain in the ED.

Shear, ML; Adler, JN; Shewakramani, S; Ilgen, J; Soremekun, OA; Nelson, S; Thomas, SH; (2010) Transbuccal fentanyl for rapid relief of orthopedic pain in the ED. The American journal of emergency medicine, 28 (8). pp. 847-52. ISSN 0735-6757 DOI:

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OBJECTIVES This study's objectives were to assess administration of a rapidly dissolving transbuccal fentanyl tablet to patients in emergency department (ED) with orthopedic extremity pain. The main end point was time required to achieve a 2-point drop on a 0 to 10 pain scale. METHODS In this double-blind trial, subjects received either transbuccal fentanyl, 100 ?g, and a swallowed placebo, or a swallowed oxycodone/acetaminophen, 5/325-mg pill, and a nonanalgesic transbuccal comparator. Pain assessment occurred every 5 minutes for an hour, and vital signs were monitored for 2 hours. RESULTS Transbuccal fentanyl was associated with faster pain relief onset (median, 10 vs 35 minutes; P < .0001). Secondary end points (pain relief magnitude, rescue medication rate, subject preference for medication on future visit) favored transbuccal fentanyl. No vital sign abnormalities or significant side effects occurred in the ED or on 100% next-day follow-up. CONCLUSIONS Transbuccal fentanyl shows promise for continued investigation as a means to safely provide rapid and effective pain relief for ED patients.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
PubMed ID: 20887903


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