title: Patients' assessment of the convenience of fentanyl HCl iontophoretic transdermal system (ITS) versus morphine intravenous patient-controlled analgesia (IV PCA) in the management of postoperative pain after major surgery.
abstract: The patient-controlled fentanyl HCl iontophoretic transdermal system (ITS) is a compact, self-contained, needle-free system that has been approved for acute postoperative pain management in hospitalized adults. The objective of the present analysis was to evaluate patients' assessment of fentanyl ITS and morphine intravenous patient-controlled analgesia (IV PCA) convenience on 7 different subscales, using a validated patient ease of care (EOC) questionnaire in 2 prospective, open-label, randomized, phase IIIb clinical trials. Patients received fentanyl ITS or morphine IV PCA (N = 1,305) for up to 72 h after total hip replacement surgery (THR study) or abdominal or pelvic surgery (APS study). For the majority of items on the patient EOC questionnaire, trends suggest that greater percentages of patients reported the most positive response for fentanyl ITS than they did for morphine IV PCA in both studies; differences were particularly noteworthy for items on the Movement subscale. In the THR study, more patients in the fentanyl ITS group were responders compared with those in the morphine IV PCA group for the subscales Confidence with Device, Pain Control, Knowledge/Understanding, and Satisfaction. In the APS study, responder rates for these subscales did not differ between treatment groups. These findings indicate that patients assessed the EOC associated with fentanyl ITS higher compared with morphine IV PCA for the management of acute postoperative pain and suggest that fentanyl ITS has the potential to improve acute postoperative pain care for patients and nurses.
authors.affiliation: Helen Keller Hospital, Sheffield, AL 35660, USA. ppenn35633@yahoo.com
authors.forename: Peg
authors.initials: P
authors.lastname: Pennington
authors.forename: Stephanie
authors.initials: S
authors.lastname: Caminiti
authors.forename: Jeff R
authors.initials: JR
authors.lastname: Schein
authors.forename: David J
authors.initials: DJ
authors.lastname: Hewitt
authors.forename: Winnie W
authors.initials: WW
authors.lastname: Nelson
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods / Q000523:psychology*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous / Q000523:psychology; D007478:Iontophoresis / Q000379:methods / Q000523:psychology*; D009020:Morphine / Q000008:administration & dosage; D015404:Nursing Methodology Research; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000523:psychology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl