Transdermal therapeutic system fentanyl
with a drug release rate of 12 mg/h should be
of special value in pediatric cancer pain control.
Such a fentanyl formulation allows for a stepwise
dose increase, similar to that reported for sustained-
release morphine.
Patients and Methods. Sixty-four male and female
pediatric patients with moderate to severe chronic
cancer pain, ages ranging 2–14 years, were
included. Patients did not receive opioids prior to
enrollment. Patients were observed for pain relief
using the Visual Analog Scale and the Wong-Baker
FACES Pain Rating Scale, play performance score,
and for side effects.
Results. There was significant improvement of
visual analog scale and FACES pain scores from
the baseline to the second day of application
(P<0.001). By the 15th day, scores reached 1.18 6
0.393 and 1.13 6 0.35, respectively (P<0.001). Play
performance scale improved from the third day of
application of the patch when compared with the
baseline (P<0.001), reaching 55.02 6 8.35
(P<0.001) at the end of the study. The sedation
score increased on the second day to 2 in 10 patients
and to 3 in 54 patients. By the seventh day, 56
patients had a sedation score of 1. All patients returned
to baseline by the 15th day. Itching was reported
in 16 cases, and erythema occurred in 10
cases. No significant side effects were reported.
Conclusion. Transdermal fentanyl was found to be
an effective, safe, and well-tolerated treatment for
pediatric cancer-related pain in opioid-naive patients
with chronic moderate to severe pain. In this
study population, evaluation of vital signs and
physical examination did not suggest any safety
concerns while using transdermal fentanyl