title: A comparison of oral transmucosal fentanyl citrate and oral oxycodone for pediatric outpatient wound care.
abstract: Analgesia for pediatric burn wound care in the outpatient clinic is constrained by time, personnel, and/or monitoring capabilities, yet may improve patient satisfaction and comfort, clinic efficiency, and patient throughput. The ideal analgesic in this increasingly common setting should be palatable, provide potent, rapid, and brief analgesia, and require minimal appropriate monitoring. Using a placebo-controlled, double-blind design we compared oral transmucosal fentanyl citrate (OTFC, approximately 10 microg/kg) and oral oxycodone (0.2 mg/kg) in 22 pediatric outpatient wound care procedures (ages 5-14 years). Pulse oximetry, vital signs, side effects, patient pain scores, and observer scores for cooperation, anxiety, and sedation were recorded. OTFC and oral oxycodone resulted in similar outcome measures and vital signs, and no significant side effects. The taste of OTFC was preferred. We conclude that OTFC and oral oxycodone are safe and effective analgesics in the setting of monitored outpatient wound care in children, and that OTFC offers the advantage of improved palatability.
authors.affiliation: Department of Anesthesiology, University of Washington School of Medicine and Harborview Medical Center, Seattle, Washington 98104, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Sharar
authors.forename: G J
authors.initials: GJ
authors.lastname: Carrougher
authors.forename: K
authors.initials: K
authors.lastname: Selzer
authors.forename: F
authors.initials: F
authors.lastname: O'Donnell
authors.forename: M S
authors.initials: MS
authors.lastname: Vavilala
authors.forename: L A
authors.initials: LA
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009061:Mouth Mucosa; D009068:Movement / Q000187:drug effects; D010045:Outpatients; D010092:Oximetry; D010098:Oxycodone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone; D005283:Fentanyl