{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:23:29Z","timestamp":1777418609516,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[1998,3,1]],"date-time":"1998-03-01T00:00:00Z","timestamp":888710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To describe the use of a continuous fentanyl infusion in an adult cancer patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 66-year-old white woman diagnosed with metastatic pancreatic carcinoma required hospital admission for pain control after receiving five different chemotherapy regimens. Morphine 2 mg\/h iv was initiated and the dosage was titrated upward to a total of 6613 mg\/d by hospital day 16. As hospital supplies of opioids became depleted over a holiday weekend, therapy was changed to a continuous infusion of hydromorphone 70 mg\/h on hospital day 17, then changed to a continuous fentanyl infusion beginning with a dosage of 500 \u03bcg\/h. The fentanyl dosage was titrated to 4250 \u03bcg\/h by hospital day 20. She died comfortably on hospital day 22 while receiving this dosage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Continuous infusions of opioids, particularly morphine and hydromorphone, are frequently used for control of cancer pain and are safe and effective when administered by this route. Transdermal fentanyl has been shown to effectively manage chronic cancer pain, and use of continuous subcutaneous fentanyl has been reported. However, reports of continuous intravenous fentanyl infusion in the cancer pain literature are limited. Our patient achieved good pain control with a continuous infusion of fentanyl 4250 \u03bcg\/h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Continuous fentanyl infusion should be considered for the treatment of cancer pain in patients requiring high doses who become refractory to other opioids, when other opioids cause intolerable adverse effects, when patients have a true morphine allergy, or when high-dose requirements threaten to deplete existing stock of alternate opioids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO:<\/jats:title>\n                    <jats:p>Describir el uso de una infusi\u00f3n continua de fentanilo en una paciente adulta con c\u00e1ncer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN DEL CASO:<\/jats:title>\n                    <jats:p>Una mujer paciente de 66 a\u00f1os de edad diagnosticada con carcinoma de p\u00e1ncreas metast\u00e1tico requiri\u00f3 hospitalizaci\u00f3n para controlar el dolor despu\u00e9s de recibir cinco r\u00e9gimenes de quimioterapia diferentes. Morfina intravenosa a raz\u00f3n de 2 mg\/h fue iniciada y titulada hasta alcanzar un total de 6600 mg de morfina\/d\u00eda al d\u00eda 16 de hospitalizaci\u00f3n. Seg\u00fan las reservas de opioides del hospital se fueron agotando durante un fin de semana de fiesta, la paciente fue cambiada a una infusi\u00f3n continua de hidromorfona 70 mg\/h el d\u00eda 17 de hospitalizaci\u00f3n, y luego fue cambiada a una infusi\u00f3n continua de fentanilo comenzando con una dosis de 500 \u03bcg\/h. La paciente fue titulada hasta alcanzar una dosis de fentanilo de 4250 \u03bcg\/h al d\u00eda 20 de hospitalizaci\u00f3n. La paciente muri\u00f3 confortablemente el d\u00eda 22 de hospitalizaci\u00f3n mientras recib\u00eda esta dosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSI\u00d3N:<\/jats:title>\n                    <jats:p>Las infusiones continuas de opioides, particularmente morfina e hidromorfona, son usadas frecuentemente para el control del dolor de c\u00e1ncer y son seguras y efectivas cuando se administraron por esta v\u00eda. Se ha demostrado que el fentanilo transd\u00e9rmico controla efectivamente el dolor de c\u00e1ncer cr\u00f3nico, y se ha reportado el uso continuo de fentanilo subcut\u00e1neo. Sin embargo, reportes en la literatura sobre dolor de c\u00e1ncer con relaci\u00f3n al uso de la infusi\u00f3n intravenosa continua de fentanilo son limitados. Esta paciente alcanz\u00f3 buen control del dolor con una infusi\u00f3n continua de fentanilo a raz\u00f3n de 4250 \u03bcg\/h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES:<\/jats:title>\n                    <jats:p>La infusi\u00f3n continua de fentanilo se debe considerar para el tratamiento del dolor de c\u00e1ncer en pacientes con requisitos de dosis alta que se vuelven refractarios a otros opioides, cuando otros opioides ocasionan efectos secundarios intolerables, cuando el paciente padece de una alergia verdadera a morfina o cuando los requisitos de dosis alta amenazan con agotar el inventario existente de opioides alternos.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF:<\/jats:title>\n                    <jats:p>Rapporter l'utilisation d'une perfusion continue de fentanyl chez un patient canc\u00e9reux.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00c9SUM\u00c9 DE CAS:<\/jats:title>\n                    <jats:p>Il s'agit d'une femme \u00e2g\u00e9e de 66 ans atteinte d'un cancer du pancr\u00e9as m\u00e9tastatique qui, apr\u00e8s avoir re\u00e7u cinq protocoles diff\u00e9rents de chimioth\u00e9rapie, est hospitalis\u00e9e pour le contr\u00f4le de sa douleur. Comme analg\u00e9sique, elle re\u00e7oit de la morphine intraveineuse \u00e0 une dose initiale de 2 mg\/h qui est graduellement augment\u00e9e jusqu'\u00e0 un total de 6600 mg de morphine par jour au jour 16 d'hospitalisation. Etant donn\u00e9 la diminution importante des r\u00e9serves de narcotiques durant une fin de semaine, la morphine fut chang\u00e9e pour une perfusion continue d'hydromorphone 70 mg\/h au jour 17 d'hospitalisation. Par la suite, la perfusion fut de nouveau chang\u00e9e pour une perfusion continue de fentanyl \u00e0 une dose de 500 \u03bcg\/h. La dose de fentanyl a du \u00eatre progressivement augment\u00e9e jusqu'\u00e0 4250 \u03bcg\/h au jour 20 afin d'obtenir un bon contr\u00f4le de la douleur. La patiente est d\u00e9c\u00e9d\u00e9e confortablement \u00e0 cette dose au jour 22.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Les perfusions continues d'analg\u00e9siques narcotiques, en particulier la morphine et l'hydromorphone, sont souvent utilis\u00e9es pour le contr\u00f4le de la douleur canc\u00e9reuse et repr\u00e9sentent une voie d'administration efficace et s\u00e9curitaire. Le fentanyl transdermique a d\u00e9montr\u00e9 son efficacit\u00e9 dans le contr\u00f4le de la douleur canc\u00e9reuse chronique et l'usage du fentanyl en perfusion continue souscutan\u00e9e est d\u00e9j\u00e0 connu. Cependant la litt\u00e9rature m\u00e9dicale est limit\u00e9e quant \u00e0 la perfusion intraveineuse continue dans la douleur canc\u00e9reuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>La perfusion continue de fentanyl doit \u00eatre consid\u00e9ree pour le traitement de la douleur canc\u00e9reuse chez les patients n\u00e9cessitant de fortes doses de narcotiques et qui, deviennent r\u00e9sistants aux autres analg\u00e9siques, lorsque les autres opiac\u00e9s occasionnent des effets secondaires intol\u00e9rables, en pr\u00e9sence d'une vraie allergie \u00e0 la morphine ou lorsque de tr\u00e8s fortes doses d'opiac\u00e9s menacent de r\u00e9duire significativement les r\u00e9serves existantes des autres narcotiques.<\/jats:p>\n                  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