Premium
The effectiveness of a long‐acting transdermal fentanyl solution compared to buprenorphine for the control of postoperative pain in dogs in a randomized, multicentered clinical study
Author(s) -
LINTON D. D.,
WILSON M. G.,
NEWBOUND G. C.,
FREISE K. J.,
CLARK T. P.
Publication year - 2012
Publication title -
journal of veterinary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.527
H-Index - 60
eISSN - 1365-2885
pISSN - 0140-7783
DOI - 10.1111/j.1365-2885.2012.01408.x
Subject(s) - medicine , fentanyl , buprenorphine , transdermal , anesthesia , confidence interval , adverse effect , randomized controlled trial , surgery , opioid , pharmacology , receptor
Linton, D. D., Wilson, M. G., Newbound, G. C., Freise, K. J., Clark, T. P. The effectiveness of a long‐acting transdermal fentanyl solution compared to buprenorphine for the control of postoperative pain in dogs in a randomized, multicentered clinical study. J. vet. Pharmacol. Therap. 35 (Suppl. 2), 53–64. A prospective, double‐blinded, positive‐controlled, multicenter, noninferiority clinical study was conducted to evaluate the safety and effectiveness of a long‐acting transdermal fentanyl solution (TFS) for the control of postoperative pain. Four hundred forty‐five client‐owned dogs of various breeds were randomly assigned to receive a single dose of TFS (2.6 mg/kg [∼50 μL/kg]) ( N = 223) applied 2–4 h prior to surgery or buprenorphine (20 μg/kg) ( N = 222) administered intramuscularly 2–4 h prior to surgery and every 6 h through 90 h. There were 159 (35.7%) males and 286 (64.3%) females ranging from 0.5 to 16 years of age and 3 to 98.5 kg enrolled. Pain was scored using the modified Glasgow Composite Pain Scale with an a priori dropout criteria of ≥8 (20 maximum score). The one‐sided upper 95% confidence interval of the mean difference between fentanyl and buprenorphine treatment failures was 5.6%, which was not greater than the a priori selected margin difference of 15%. Adverse events attributed to either treatment were minimal in impact and were approximately equal between groups. Sustained plasma fentanyl concentrations provided by a single pre‐emptive dose of TFS are safe and effective and are noninferior to repeated injections of buprenorphine in controlling postoperative pain over 4 days. This long‐acting fentanyl formulation provides veterinarians with a novel, registered option for the control of postoperative pain in dogs that improves dosing compliance and potentially mitigates the disadvantages of oral, parenteral, and patch delivered opioids.