| Fentanil intranasal para control del dolor: estado actual con foco en las consideraciones de los pacientes. |
Intranasal fentanyl for pain control: current status with a focus on patient considerations. Prommer E, Thompson L. Division of Hematology/Oncology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USA. Patient Prefer Adherence. 2011 Mar 18;5:157-64.Abstract Of several newer delivery systems under development and investigation for the administration of opioids, the intranasal route has received a substantial amount of attention. Intranasal administration is a convenient form of delivery that is applicable to several opioids. It has the potential for self-administration, combined with a rapid onset of action, allowing for patient-controlled analgesia. In clinical practice, intranasal administration has been found to be a reliable drug delivery method that is familiar to patients. Intranasal opioids have proven to be useful in both in-hospital and out-of-hospital pain management settings. Fentanyl, a highly lipophilic step 3 opioid, has been evaluated for intranasal administration. The purpose of this review is to examine the role of the nasal route of opioid administration and examine the evidence base for the use of fentanyl intranasally. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090376/pdf/ppa-5-157.pdf |
| Eficacia y seguridad de butorfanol transnasal para alivio del dolor después de cirugía anal |
Efficacy and safety of transnasal butorphanol for pain relief after anal surgery.
Mai CM, Wan LT, Chou YC, Yang HY, Wu CC, Jao SW, Hsiao CW.
Department of Surgery, Huailien Armed Forces General Hospital, Huailien, Taiwan, ROC.
World J Gastroenterol. 2009 Oct 14;15(38):4829-32.
Abstract
AIM: To compare the analgesic properties and efficacy of transnasal butorphanol with intramuscular meperidine after anal surgery. METHODS: Sixty patients who underwent fistulectomy were enrolled in the study from January 2006 to December 2007. They were randomly divided into transnasal butorphanol (n = 30) or intramuscular meperidine (n = 30) treatment groups. Assessment of postoperative pain was made using a visual analogue scale (VAS). The VAS score was recorded 6 h after the completion of surgery, before receiving the first dose of analgesic, 60 min after analgesia and the next morning. Any adverse clinical effects such as somnolence, dizziness, nausea or vomiting were recorded. Satisfaction with narcotic efficacy, desire to use the particular analgesic in the future and any complaints were recorded by patients using questionnaires before being discharged. RESULTS: Forty-two men and eighteen women were included in the study. There were no significant differences in VAS scores between the groups within 24 h. Length of hospital stay and the incidence of adverse effects between the groups were similar. In addition, most patients were satisfied with butorphanol nasal spray and wished to receive this analgesic in the future, if needed. CONCLUSION: Butorphanol nasal spray is effective for the relief of pain after fistulectomy. However, it offered patients more convenient usage and would be suitable for outpatients.
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| Opioides por vía intranasal en el tratamiento del dolor agudo |
C. Añez Simón, M. Rull Bartomeu, A. Rodríguez Pérez, A. Fuentes Baena Servicio de Anestesiología, Reanimación y Terapéutica del Dolor y M. Paliativa. Hospital Universitario de Tarragona "Joan XXIII". Servicio de Anestesiología y Reanimación. Hospital Universitario de Gran Canaria "Dr. Negrin". Rev. Esp. Anestesiol. Reanim. 2006; 53: 643-652.Resumen La vía intranasal es una vía de administración transmucosa que aporta como ventajas la facilidad de administración, es incruenta, bien aceptada por el paciente y carece de efecto de primer paso hepático. La mucosa nasal supone una superficie extensa muy vascularizada recubierta por epitelio ciliar pseudoestratificado, secretora de moco sometido a un movimiento mucociliar que puede determinar el tiempo de contacto entre los fármacos y la superficie. Los factores que influyen en la absorción son de tipo anatómico, fisiológico y otros relacionados con las propiedades del fármaco y los sistemas de administración. Revisamos los artículos publicados sobre el uso de fentanilo, meperidina, diamorfina y butorfanol utilizados por vía intranasal para el tratamiento del dolor agudo. Los efectos adversos sistémicos son similares a los descritos para la vía intravenosa, siendo los más frecuentes somnolencia, náuseas y vómitos. En cuanto a los efectos adversos locales, se ha descrito sensación de quemazón con meperidina y mal sabor. Palabras clave: Dolor agudo. Analgesia. Opioides. Vía intranasal. Farmacocinética. Farmacodinámica. Efectos adversos. http://www.sedar.es/restringido/2006/n10_2006/6.pdf |
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