title: The efficacy of transdermal fentanyl for pain relief after endoscopic submucosal dissection: a prospective, randomised controlled trial.
abstract: OBJECTIVE
  Epigastric pain management following endoscopic submucosal dissection is an important consideration. This study aimed to investigate the utility and safety of fentanyl patches for pain relief after the procedure.
  
  
  METHODS
  Patients who were scheduled to undergo endoscopic submucosal dissection were prospectively randomised to either a transdermal fentanyl patch group or a placebo control group. An additional pethidine was intravenously administered when pain developed and a numerical rating scale was used to evaluate both pre- and post-procedural pain.
  
  
  RESULTS
  One hundred and ten patients were randomly assigned to receive either a 12 mcg/h fentanyl patch or a control patch on the night before the procedure. The fentanyl patch group had significantly lower pain scores immediately following the procedure (mean, 5.17 vs. 4.26, p=0.030). Maximal pain scores during the first 24 h (5.43 vs. 4.46, p=0.038) and pain scores on the day after the procedure (2.98 vs. 1.20, p<0.001) were also lower in the fentanyl patch group. In addition, the fentanyl patch group required a significantly lower dose of pethidine for pain management (24.54 vs. 11.25, p=0.004).
  
  
  CONCLUSIONS
  The application of a transdermal fentanyl patch is an effective, convenient, and safe method to control epigastric pain after endoscopic submucosal dissection.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Hyuk Soon
authors: HS
authors: Choi
authors: Kyoung-Oh
authors: KO
authors: Kim
authors: Hoon Jai
authors: HJ
authors: Chun
authors: Bora
authors: B
authors: Keum
authors: Yeon Seok
authors: YS
authors: Seo
authors: Yong Sik
authors: YS
authors: Kim
authors: Yoon-Tae
authors: YT
authors: Jeen
authors: Soon Ho
authors: SH
authors: Um
authors: Hong Sik
authors: HS
authors: Lee
authors: Chang Duck
authors: CD
authors: Kim
authors: Ho Sang
authors: HS
authors: Ryu
mesh_terms: D000279:Administration, Cutaneous; D061605:Administration, Intravenous; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004210:Dissection; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D013274:Stomach Neoplasms / Q000601:surgery*; D057968:Transdermal Patch
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine; D005283:Fentanyl