Fentanyl
CPT4 code
Name of the Procedure:
Fentanyl Administration
Common name(s): Fentanyl Injection, Fentanyl Patch, Fentanyl Transdermal System
Technical or medical terms: Fentanyl Citrate, Actiq, Duragesic
Summary
Fentanyl is a potent opioid pain reliever administered in various forms including injections, patches, or lozenges. It is often used to manage severe pain, particularly in patients who require long-term around-the-clock pain management.
Purpose
Fentanyl is primarily used to treat severe chronic pain, such as pain from cancer, surgery, or severe injury. The goal is to provide immediate and sustained pain relief, improving the patient's quality of life and functionality.
Indications
- Severe chronic pain not adequately controlled with other pain medications
- Acute pain management in surgical or post-surgical patients
- Patients with cancer-related pain
Preparation
- Patients may need to fast or adjust their current medications as advised by the healthcare provider.
- Pre-procedure assessments may include reviewing the patient's medical history, current medications, and performing physical examinations to evaluate suitability.
Procedure Description
- Administration Form: Fentanyl can be given as an injection, a transdermal patch, or a lozenge.
- Injection: Administered intravenously or intramuscularly by a healthcare professional in a controlled setting.
- Transdermal Patch: Applied to the patient’s skin, typically by the patient or caregiver, and provides continuous pain relief over a specified period.
- Lozenge: Placed in the mouth to dissolve, providing rapid pain relief through mucosal absorption.
Equipment: Syringes, transdermal patches, lozenges
Anesthesia or Sedation: Not typically required for administration
Duration
The administration takes a few minutes, but the duration of pain relief varies:
- Injection: Immediate effect lasting a few hours
- Patch: Continuous effect for up to 72 hours
- Lozenge: Rapid onset with effects lasting a few hours
Setting
- Injection: Hospital, outpatient clinic, or home under professional supervision
- Patch: Home or medical facility
- Lozenge: Home or medical facility
Personnel
- Injected: Administered by a doctor, nurse, or trained healthcare professional
- Patch and Lozenge: Can be self-administered or applied by a caregiver after receiving proper instructions
Risks and Complications
- Common risks: Nausea, vomiting, constipation, dizziness, drowsiness
- Serious risks: Respiratory depression, hypotension, addiction, overdose
Benefits
- Provides effective and potent pain relief
- Improves quality of life and functionality
- Rapid onset of action provides quick relief for acute pain episodes
Recovery
- Monitor for side effects and manage symptoms as necessary
- Patients using patches or lozenges should follow specific usage instructions and adhere to prescribed dosages
- Regular follow-up appointments may be necessary to adjust dosage and check for effectiveness and side effects
Alternatives
- Other opioid medications (e.g., morphine, oxycodone)
- Non-opioid pain relievers (e.g., NSAIDs, acetaminophen)
- Non-pharmacological treatments (e.g., physical therapy, acupuncture)
Pros: Fentanyl is more potent and faster-acting for severe pain
Cons: Higher risk of respiratory depression and addiction compared to other opioids
Patient Experience
- During: Injection can cause a brief sting; patches and lozenges are generally painless to apply
- After: May experience drowsiness, relaxation, or side effects such as nausea; management strategies include staying hydrated and eating light meals
- Pain management: Healthcare providers may prescribe additional medications to treat side effects and ensure patient comfort