title: Meta-analysis of the efficacy of the fentanyl iontophoretic transdermal system versus intravenous patient-controlled analgesia in postoperative pain management.
abstract: OBJECTIVE
  This meta-analysis was conducted to analyze and compare the efficacy outcomes associated with the fentanyl iontophoretic transdermal system (ITS) and morphine intravenous (IV) patient-controlled analgesia (PCA) in the management of postoperative pain.
  
  
  METHODS
  This meta-analysis assessed the efficacy of the fentanyl ITS versus morphine IV PCA using data from four randomized, active-controlled trials (n = 1271 fentanyl ITS and 1298 morphine IV PCA patients). Main outcome measures were patient global assessment (PGA) of the method of pain control at 24 h.
  
  
  RESULTS
  Fentanyl ITS and morphine IV PCA did not significantly differ regarding 'good' and 'excellent' ratings on the PGA of the method of pain control at 24 h (odds ratio = 0.95, p = 0.66), however, fentanyl ITS was superior in terms of 'excellent' PGA ratings at that time point (odds ratio = 1.53, p < 0.0001). No significant differences were found in weighted mean pain intensity scores at 24, 48 and 72 h.
  
  
  CONCLUSIONS
  In this meta-analysis, fentanyl ITS was as efficacious as morphine IV PCA and may offer additional benefits as demonstrated by its 'excellent' PGA ratings.
authors.affiliation: West Haven VA Medical Center , West Haven, CT , USA.
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Sinatra
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Viscusi
authors.forename: Li
authors.initials: L
authors.lastname: Ding
authors.forename: Hassan
authors.initials: H
authors.lastname: Danesi
authors.forename: James B
authors.initials: JB
authors.lastname: Jones
authors.forename: Stefan
authors.initials: S
authors.lastname: Grond
mesh_terms: D000279:Administration, Cutaneous; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D007478:Iontophoresis; D009020:Morphine / Q000008:administration & dosage; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl
keywords: fentanyl; iontophoretic transdermal system; morphine; patient global assessment of the method of pain control; patient-controlled analgesia; postoperative pain