Effect of Transdermal Fentanyl Patches on the Motility of the Sphincter of Oddi

Koo, Hyun Cheol; Moon, Jong Ho; Choi, Hyun Jong; Hwang, Kyoung Hwa; Maeng, Hyo Jin; Kim, Hyung Ki; Park, Jong Kyu; Hong, Su Jin; Cheon, Young Koog; Cho, Young Deok; Lee, Joon Seong; Lee, Moon Sung

Abstract

BACKGROUND/AIMS
Pain is one of the most troublesome symptoms of pancreatitis. Transdermal fentanyl patches (TFPs) are long-acting analgesics with a reduced risk of dependency. This prospective study evaluated the effect of TFPs on sphincter of Oddi (SO) motility for the management of pain in pancreatitis.
METHODS
SO manometry (SOM) was performed using triple-lumen catheters anterogradely inserted through the percutaneous transhepatic route during cholangioscopy in 16 patients. The basal pressure, amplitude, and frequency of the SO were assessed before and after applying a TFP at 24 hour at doses of 25 and 12.5microgram/hr, respectively.
RESULTS
Two of 16 patients receiving a 25microgram/hr. TFP were excluded because of adverse side effects (headache and/or nausea). The mean basal pressure, amplitude, and frequency of SOM did not change significantly in the 25microgram/hr TFP group (n=4 patients). Parameters of SO function also did not significantly change in the 12.5microgram/hr TFP group (n=11 patients).
CONCLUSIONS
TFPs below a dose of 25microgram/hr may not affect the motility of the SO. Administration of TFPs at lower dosages seems to be a safe analgesic treatment for the pain control of patients with pancreatitis without affecting the function of the SO.