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Sorry for spelling and grammar, I am writing this on a break during a case.
Due to the low molecular weight, Fentanyl can be adminstered both transdermal,and submucosal (both oral and nasal). It is approximetly 250 times more potent than Morphine (the gold standard for opiods).
We use it almost exculsively in anesthesia due to the low incidence of side effects; no histiamine release, allergic RXN's and negative GI effects.
The nice thing about Fentanly is that peak analgesia is reached within 5 mins. after IV adminstration. (Morphine does not reach peak analgesic efficency for 20 to 25 mins after IV adminstration. Although there is of course some immediate affects noted.)
The theraputic half-life is short so it is very perdicatable.
The down side of using Fentanyl is it's potency. This is a drug used by anesthesia providers with the ablity to maintain airways.
Ridged Chest is seen with rapid IV adminstration along with resp. depression. If you use it, you better have airway adjunts avalible.
Adminstering Fentanyl submucosal or transdermally is sometimes a crap shoot due to the varialble absorbtion rates. so under and overdoseage is possible.
I use the stuff everyday and love it. But in settings other than a controlled enviorment I would be hesitent about using it. ie in a field enviorment. Roger Coleman, CRNA
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