PHILADELPHIA -- A needle-free, self-contained
fentanyl patient-controlled transdermal system (PCTS) is as effective for
post-surgical pain management as the traditional intravenous pump (IV), while
giving patients more mobility and freeing nurses to devote more time to
patient care. The study led by researchers from Jefferson Medical College of
Thomas Jefferson University, Philadelphia, appears in the March 17, 2004 issue of
the Journal of the American Medical Association (JAMA).
The multi-center study conducted at more than 30 sites nationwide
demonstrated that a button-activated, fentanyl system that delivers pain
medication through the skin could eliminate the need for IVs for post-surgical
pain relief. The study was led by Eugene Viscusi, MD, director of the Acute
Pain Management Service at Thomas Jefferson University Hospital in Philadelphia.
The fentanyl transdermal system would also offer the advantage of a needle-
free, pre-programmed medication system in a small, self-contained unit.
"This is a miracle of miniaturization," said Viscusi, assistant
professor of anesthesiology at Jefferson Medical College of Thomas Jefferson
The system, known as E-TRANS fentanyl PCTS, is approximately the size of a
credit card, self-adherent to the skin, pre-programmed and needle-free. It
delivers pain medication across the skin with a low level electric current
when activated by the patient with a small button on the surface of the
The fentanyl transdermal system could be used for patients with moderate
to severe post-operative pain after most surgeries including joint
replacement, prostate surgery or gynecological procedures, the Jefferson
"Anyone who has ever had surgery remembers the discomfort of having IVs
and needles," Viscusi said. "This patch system has a huge potential
The PCTS, placed on an inpatient's upper arm or chest by adhesive on the
back of the patch, transmits the pain medication through the skin at the push
of a button, explained Viscusi. When the patient pushes the button for
pain, PCTS delivers medication over 10 minutes. The system has a "lock out"
feature so a patient cannot administer more pain medication than is prescribed
for him. The system is replaced every 24 hours as needed.
Without any tubing or equipment to encumber a patient's movement, the
patient can freely move about to perform needed physical therapy, Viscusi
The PCTS could also be a boon to nurses as nursing staff would not have to
spend time setting up an IV and the time-consuming standard pain pump
currently used. This could allow nurses to devote more time to patient care
instead of technology, he said.
The fentanyl patch system studied is currently under review by the U.S.
Food and Drug Administration (FDA) and was developed by Ortho-McNeil
Pharmaceuticals, Inc. and the ALZA Corporation, both subsidiaries of Johnson
Source: Thomas Jefferson University Hospital