title: Iontophoretic transdermal fentanyl for the management of acute perioperative pain in hospitalized patients.
abstract: BACKGROUND
  Intravenous (I.V.) morphine administered through a patient-controlled system currently represents the gold standard treatment for moderate to severe acute postoperative pain. To fix the limitations showed by the available I.V. patient-controlled analgesia (PCA) systems that may restrict its use in the clinical practice a needle-free, iontophoretic, fentanyl patient-controlled transdermal system has been developed and recently approved by the United States Food and Drug Administration (FDA) and by the European Medicines Agency (EMA).
  
  
  METHODS
  This review aims at describing the technology, pharmacology and clinical efficacy of fentanyl iontophoretic transdermal system (ITS) in the treatment of acute pain. A literature search was conducted in the PUBMED database using the term 'fentanyl iontophoretic transdermal system' through September 2015 and results from the main clinical trials are discussed.
  
  
  CONCLUSIONS
  In 2015, the appropriate treatment of acute pain after surgery is still a challenge and it represents a primary goal in the care of the surgical patient. When regional analgesia techniques are not applicable and systemic analgesia is required, patient controlled systems represent the standard of care for opioid administration. The fentanyl ITS presents several potential advantages compared to the currently used PCA devices. In particular, it does not require intravenous lines and eliminates the potential for drug administration errors, observed with manually programmed standard PCA devices. Nevertheless, further studies are needed to address eventual inter-individual variability especially for opioid tolerant patients.
authors.affiliation: a Department of Medical and Surgical Sciences , Anesthesia and Intensive Care Unit, Policlinico S. Orsola-Malpighi , Bologna , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fanelli
authors.affiliation: a Department of Medical and Surgical Sciences , Anesthesia and Intensive Care Unit, Policlinico S. Orsola-Malpighi , Bologna , Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Sorella
authors.affiliation: b Division of Acute Interventional Perioperative Pain and Regional Anesthesia, Department of Anesthesiology , University of Pittsburgh Medical Center Presbyterian-Shadyside Hospitals , Pittsburgh , PA , USA.
authors.forename: Jacques E
authors.initials: JE
authors.lastname: Chelly
mesh_terms: D059787:Acute Pain / Q000188:drug therapy; D000279:Administration, Cutaneous; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002986:Clinical Trials as Topic; D005283:Fentanyl / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006760:Hospitalization; D006801:Humans; D007478:Iontophoresis; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*; D059035:Perioperative Period
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: Fentanyl; acute postoperative pain; iontophoretic system; patient controlled analgesia; transdermal