INTRANASALE OPIOIDANALGESIE

H.W. Striebel, C. Spies and R. Schwagmeier

Aus Wissenchaft und Klinik

 There has been an ongoing search for alternative modes of opioid administration. Over the last few years the intranasal mode of opioid administration was investigated and seems to be especially promising. In a recently published study we demonstrated that 71% of intranasally administered fentanyl is absorbed. Due to the rapid rise in fentanyl plasma concentrations following intransal use, this route of administration seems to be suitable for demand-adapted titration. This was demonstrated in several of our recently published papers. Patients acceptance of the intranasal route of opioid administration was high. Recently we developed a device for patient controlled intranasal analgesia (PCINA). This PCINA-device displays safety features which are comparable to a conventional intravenous PCA-device. The handling of the PCINA-device is easy and the first results are promising. PCINA offers a new perspective in the management of pain. It may be especially of value in the late postoperative period when many patients still complain of considerable pain but no longer have a venous access. The intranasal use of titrated fentanyl seems also to be suitable in the management of breakthrough cancer pain.