Postoperative Pain Management With a Patient-Controlled Transdermal Delivery System for Fentanyl

Peter J. S. Koo


Am J Health Syst Pharm. 2005;62(11):1171-1176. 

In This Article


Fentanyl hydrochloride PCTS will be supplied in a sealed foil pouch. Each system can be tested to ensure that it is operational while still in the pouch by locating the on-demand button through the foil and pressing it twice. An audible beep will indicate that the system has been activated, which will be followed by a series of beeps indicating that no dose was delivered (the system must be attached to the patient for the electronic circuit necessary for drug delivery to be completed). Testing the system in this manner does not initiate the 24-hour, 80-dose active delivery period, since no dose has been delivered.

The device should be applied to clean, dry, nonirritated, intact skin on the upper arm or chest. Other application sites, such as the legs or abdomen, have not been studied; therefore, application to such sites is not recommended. The application site is prepared by clipping any hair in the area and cleansing with a sterile alcohol wipe. If treatment for longer than 24 hours (or 80 doses) is required, a different application site should be used for each successive system. The system is applied by removing the clear plastic liner from the bottom of the device, placing it on the patient, and applying pressure for 15 seconds. Occasionally, systems do not adhere completely to the patient and may need to be secured with tape; 1.6-3.1% of systems applied in the studies described earlier required tape to maintain adhesion.a Pressing the on-demand button once during drug delivery displays the approximate number of doses administered.

Before beginning treatment with PCTS, patients should receive bolus doses of opioid analgesics as necessary to achieve comfort.

aData on file, ALZA Corporation, Mountain View, CA, protocols C-2000-008, C-2000-007, and C-2001-011.


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