title: [Opioid induction using rapid release drugs and the shift to fentanyl patches].
abstract: METHODS
  From April 2011 to March 2013, 20 patients with cancer pain that was not controlled by non-opioid analgesics were treated with a short-acting opioid for cancer pain management.The primary carcinoma sites were the stomach( n=5), colo-rectum(n=5), lungs(n=3), urinary bladder(n=2), breast(n=2), pancreas(n=2), and liver(n=1). The analgesic effects and adverse events were evaluated, and a shift to fentanyl patches was made for patients whose cancer pain was relieved.After the shift, the efficiency and safety were validated.
  
  
  RESULTS
  All 6 patients with a numeric rating scale (NRS)less than 5 at the time of opioid induction had a good analgesic effect, and in only 1 patient, grade 2 constipation and grade 3 anorexia was observed.Of the 14 patients who had an NRS of 6 or greater, 11 had a good analgesic effect.However, 3 patients experienced no effect, and their survival periods after opioid induction were very short.In the 11 patients with good pain control, only 3 patients exhibited grade 2 adverse events.Nine patients out of 17 with a good analgesic effect caused by short-acting opioids were shifted to fentanyl patches, and 8 patients were under good analgesic control for 2 weeks or more.
  
  
  CONCLUSIONS
  Opioid induction using rapid release drugs was effective and safe.However, these drugs should be clinically considered at an early stage.Furthermore, in patients where a shift to a fentanyl patch was possible, good long-term pain control was achieved.
authors.affiliation: Dept. of Surgery,Omori Red Cross Hospital.
authors.forename: Shin
authors.initials: S
authors.lastname: Sasaki
authors.forename: Taiki
authors.initials: T
authors.lastname: Morohashi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Miho
authors.initials: M
authors.lastname: Ejima
authors.forename: Yu
authors.initials: Y
authors.lastname: Tsujikawa
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Emi
authors.initials: E
authors.lastname: Terai
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl