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The Journal of the American Board of Family Practice 17:388-390 (2004)
© 2004 American Board of Family Practice

Brief Report

High-Dose Fentanyl Patch for Cancer Pain

Sasson Menahem, MD and Pesach Shvartzman, MD

From the Pain and Palliative Unit, Department of Family Medicine, Sial Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, and Clalit Health Services—South District, Beer-Sheva, Israel

Correspondence: Address correspondence to Dr. Sasson Menahem, Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva, 84105, Israel (e-mail: sassonm{at}bezeqint.net)

Abstract

Objective: To describe a successful experience with a high dose (1000 µg/hr) of transdermal fentanyl for cancer pain relief.

Case Report: A 62-year-old man suffering from rectal carcinoma was treated by our home care hospice unit during his last 3.5 months of life. At admission to our home care unit, he suffered mostly from severe anal pain (verbal pain scale of 10/10) due to advanced disease. He was then on 150 µg/hr transdermal fentanyl. Adjuvant therapy with amitriptyline 50 mg/day and dexamethasone 4 mg/day was added, but it did not relieve his pain. The dose of transdermal fentanyl was increased gradually to 1000 µg/hr with good pain control (verbal pain scale of 1 to 4/10 most of the time). Before his death, he was mentally alert with good pain control.

Conclusions: High doses of transdermal fentanyl (1000 µg/hr; 10 patches) should be considered for pain relief in cancer patients.






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Copyright © 2004 by the American Board of Family Medicine.