The efficacy of transdermal fentanyl for pain relief after endoscopic submucosal dissection: A prospective, randomised controlled trial.

Abstract: Objective: Epigastric pain management following endoscopic submucosal dissection is an important consideration. This study aimed to investigate the utility and safety of fentanyl patches for pain relief after the procedure. Methods: Patients who were scheduled to undergo endoscopic submucosal dissection were prospectively randomised to either a transdermal fentanyl patch group or a placebo control group. An additional pethidine was intravenously administered when pain developed and a numerical rating scale was used to evaluate both pre- and post-procedural pain. Results: One hundred and ten patients were randomly assigned to receive either a 12mcg/h fentanyl patch or a control patch on the night before the procedure. The fentanyl patch group had significantly lower pain scores immediately following the procedure (mean, 5.17 vs. 4.26, p =0.030). Maximal pain scores during the first 24h (5.43 vs. 4.46, p =0.038) and pain scores on the day after the procedure (2.98 vs. 1.20, p <0.001) were also lower in the fentanyl patch group. In addition, the fentanyl patch group required a significantly lower dose of pethidine for pain management (24.54 vs. 11.25, p =0.004). Conclusions: The application of a transdermal fentanyl patch is an effective, convenient, and safe method to control epigastric pain after endoscopic submucosal dissection. [Copyright &y& Elsevier]