Bortolussi, R., Zotti, P., Matovic, M., Morabito, A., Bertuzzi, C., Caserta, M., . . . Roscetti, A. (2016). A phase II study on the efficacy and safety of procedural analgesia with fentanyl buccal tablet in cancer patients for the placement of indwelling central venous access systems. Supportive Care in Cancer, 24, 1537–1543.
To determine the effectiveness of using fentanyl buccal tablets (FBT) to reduce pain related to placing indwelling vascular access ports in opioid-naïve patients with cancer
Patients were assessed on anxiety and pain preoperatively. Ten minutes prior to the procedure, 100 mcg FBT was administered. Patients were assessed postoperatively on pain during the procedure. Side effects and symptoms were monitored during, after, and four hours after the procedure. Those with anesthesia-related nausea received one metoclopramide tablet one hour prior to the procedure, and those with extreme pain during the procedure received rescue therapy of 30 mg ketorolac or 20 drops of tramadol if allergic to NSAIDS/ASA.
Use of FBT pre-procedure to reduce pain perception is a plausible intervention for pain control in those receiving a port but is not without side effects. Further consideration to prevent or ameliorate side effects and further studies with a larger population should be considered.
Nursing would need to be prepared for management of side effects and potential fall risk post-procedure. Side effects could require restructuring the postoperative environment to meet the needs of the patients or require follow-up beyond four hours.