{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T15:51:27Z","timestamp":1770997887797,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,5,21]],"date-time":"2016-05-21T00:00:00Z","timestamp":1463788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2017,2]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Postoperative pain management protocols that use patient\u2010controlled analgesia (PCA<\/jats:styled-content>) can hinder mobility due to attached machinery and tubing. Immobility in the postoperative setting can increase complications, length of stay (LOS<\/jats:styled-content>), and costs. Early and enhanced mobilization can reduce the cost of care while improving patient outcomes. A needle\u2010free, compact, patient\u2010activated, and portable fentanyl iontophoretic transdermal system (fentanyl ITS<\/jats:styled-content>, IONSYS<\/jats:styled-content>; The Medicines Company, Parsippany NJ<\/jats:styled-content>) has been shown to provide comparable efficacy and tolerability to intravenous (IV<\/jats:styled-content>) PCA<\/jats:styled-content> morphine that promotes improved mobility.<\/jats:p><\/jats:sec>Methods<\/jats:title>This pooled analysis of 1,882 patients across three randomized, controlled trials compared fentanyl ITS<\/jats:styled-content> to IV PCA<\/jats:styled-content> morphine for postoperative pain management. Outcomes of patient mobility were assessed by a validated Patient Ease of Care Questionnaire that was given to patients, patients' nurses, and physical therapists involved in patient care. Safety was assessed via spontaneously reported treatment\u2010emergent adverse events (TEAE<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>Fentanyl ITS<\/jats:styled-content> significantly improved overall patient mobility, each mobility subscore (P<\/jats:italic> < 0.0001) across all demographics (male\/female; elderly\/non\u2010elderly; normal BMI<\/jats:styled-content>\/overweight\/obese\/morbidly obese) and surgery types, and was consistent across nurses and physical therapists mobility assessments. TEAE<\/jats:styled-content>s were generally similar between the two groups. However, more patients reported an opioid\u2010related TEAE<\/jats:styled-content> with morphine IV PCA<\/jats:styled-content> than with fentanyl IV PCA<\/jats:styled-content> (P<\/jats:italic> = 0.003).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Due to improved mobility with fentanyl ITS<\/jats:styled-content>, complications are expected to be less frequent than with IV PCA<\/jats:styled-content> and epidural PCA<\/jats:styled-content>. Incorporation of this strategy into postoperative pain management protocols may reduce LOS<\/jats:styled-content> and total hospital costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12432","type":"journal-article","created":{"date-parts":[[2016,5,23]],"date-time":"2016-05-23T21:38:23Z","timestamp":1464039503000},"page":"197-207","source":"Crossref","is-referenced-by-count":14,"title":["Patient\u2010Controlled Fentanyl Iontophoretic Transdermal System Improved Postoperative Mobility Compared to Intravenous Patient\u2010Controlled Analgesia Morphine: A Pooled Analysis of Randomized, Controlled Trials"],"prefix":"10.1111","volume":"17","author":[{"given":"Ali","family":"Oliashirazi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Marshall University Huntington West Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Wilson\u2010Byrne","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Marshall University Huntington West Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklin D.","family":"Shuler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Marshall University Huntington West Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javad","family":"Parvizi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery The Rothman Institute Thomas Jefferson University Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001786-200207000-00002"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6672-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0b013e31824590e6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/58.11.M1042"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14966-5"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(93)90013-5"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2001.045007795.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rapm.2006.08.011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.11.1333"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2006.03.010"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00063198-200209000-00004"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199904000-00017"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2006.00257.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aem102"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2003.10.026"},{"key":"e_1_2_6_17_1","unstructured":"ER Viscusi G Harding S Vallow 2006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2007.04284.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003643-200606001-00786"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990802631321"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60202-0"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(02)00144-X"},{"key":"e_1_2_6_23_1","unstructured":"ChoeY DielsJ JanagapC KavanaghS.Incidence of complications associated with postoperative pain management modalities in US hospitals in Annual Meeting of the Society of Anesthesiologists.2006: Chicago IL. p. 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