Objective: To evaluate the effects and side effects of transdermal fentanyl for the elderly patients with cancer pain.
Methods: A multicenter clinical test was conducted among 1,664 patients with cancer pain, aged 65 - 90 with a median age of 71, 879 (52.8%) of which used opioid for the first time, from 136 hospitals in 23 provinces in China. All patients received transdermal fentanyl to treat cancer pain with the mean dose of fentanyl of 31.34 micro g/h (25 - 150 micro g/h) initially, and 40.59 micro g/h and 47.50 micro g/h (25 - 200 micro g/h) at day 15 and day 30. They were asked to record the attacks of pain, quality of life, and any side effects of the treatment.
Results: The baseline pain intensity score was 7.34. On days 1, 3, 6, 9, 15, and 30, the mean pain scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, and 1.64 (all P < 0.01) respectively. The effective rate was 97.18%. The fine life quality rate was 25.4% before treatment, and was 71.15% and 73.04% at day 15 and day 30 (both P < 0.01). The commonest side effects included constipation (10.70%), nausea (11.96%), dizziness (6.85%), vomiting (3.85%), sleepiness (2.40%), and respiratory depression (0.12%). The incidence of constipation was related with age, the incidence of vomiting and difficulty of urination was related with gender. 86.2% patients preferred to receive transdermal fentanyl.
Conclusion: Safe, convenient, and capable to improve the quality of life, transdermal fentanyl is effective and worth recommending as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain. The initial dose is recommended as 25 micro g/h.