Evaluation of fentanyl use in non-malignant pain

The aim of this study was to evaluate the efficacy of fentanyl usage for analgesia in non-malignant hospitalized patients with severe pain. The use of fentanyl in recurrent hospitalizations of 32 patients with non-malignant pain was also examined separately, and a total of 138 applications were included in the study. Patients' age, diagnosis, dose and route of fentanyl administration, number of days administered, type and duration of analgesic treatment given before fentanyl administration, drugs administered concomitantly with fentanyl (opioid/nonopioid), VAS value before fentanyl drug use started, fentanyl administration route (IV, sublingual, TTS), adverse events, hemoglobin, hematocrit, renal (urea/creatinine) and hepatic (ALT/AST) function test results, and red blood cell suspension and/or blood transfusion during administration of fentanyl for sickle cell patients were recorded. Statistically, p<0.05 was considered significant. The mean age of the patients was 27.0 ± 11.2. 65.6% (n:21) of the patients were male and 34.3% (n:11) were female. It was determined that bolus fentanyl doses were applied higher in males according to gender (p<0.002). In age grouping, it was determined that the number of patients receiving fentanyl was highest between the ages of 21-44 (58.6% n:81). It was determined that the age range of 21-44 was the group who received the highest dose of TTS fentanyl (p<0.01). According to age groups, the lowest dose and the highest dose of TTS form fentanyl administered during a hospitalization period were found to be higher in the 21-44 age group (respectively p<0.01; p<0.01). The median VAS value before fentanyl use was 6.0 ± 0.1. A significant correlation was found between the VAS values of the patients and the highest dose of TTS fentanyl administered during a hospitalization period (p<0.033). The median value of bolus fentanyl administered to the patients was 200 ± 42.9mcq, and the median value of TTS fentanyl was 25 ± 2.9mcq. It was determined that bolus fentanyl and TTS fentanyl administered to the patients were higher in repeated administrations compared to the first administration dose (respectively p<0.026; p<0.01). Fentanyl use was found to be higher in all forms of patients with SCA than in patients with other diagnoses (p<0.001). It was determined that 42% (n:58) of the patients needed additional opioid use, 7.2% (n:10) needed additional non-opioid analgesic use and 14.5% (n:20) needed co-analgesic use. It was found that the amount of TTS used was statistically higher in patients who needed additional opioids than those who did not (p<0.01). The highest dose of TTS was found to be higher in patients who needed additional non-opioids during the follow-up period than those who did not need it (p<0.033). The lowest and highest dose of TTS was found to be higher in patients with normal liver function tests during the follow-up period (respectively p<0.003; p<0.039). In conclusion; It was determined that bolus and transdermal forms of fentanyl were effective in controlling pain in non-malignant pain, especially in patients with SCA. Considering the underlying diseases of the patient, it was concluded that the administration of fentanyl in severe pain could improve the quality of life in a short time.