- Preoperative analgesia:
- IV/IM 50-100mcg 30 minutes prior to surgery
- General anaesthesia:
- Minor surgery: IV 0.5-2 mcg/kg/dose
- Major surgery: Initially maintenance infusion IV of 2-20mcg/kg/dose, 1-2 mcg/kg/hour.
- Discontinue infusion 30-60 min prior to end of surgery.
- Total fentanyl doses limited to 10-15mcg/kg for fast tracking and early extubation.
- Postoperative pain:
- IV/IM 50-100mcg every 1-2 hours PRN OR IV 0.5-1.5 mcg/kg/hour PRN
Injection:
- 50mcg/mL
- 100mcg/mL
Transdermal patch:
- 4.2mg per patch
- 8.4mg per patch
- Use lowest effect dose for the shortest effective duration
- It should be titrated slowly for patients >65 years.
- Can be used diluted or undiluted.
Synthetic opioid analgesic.
It binds to opioid receptors inhibiting ascending pain pathways therefore altering response to pain.
- Respiratory depression
- Somnolence
- Respiratory arrest
- Hypotension
- Arrhythmias
- Bradycardia
- Muscle rigidity
- Itching
- Post-operative shivering
- Bronchoconstriction
- Urinary retention
- Euphoria
- Hallucinations
- Dyspnea
- Biliary spasm
- Impaired coordination
- Respiratory depression
- Acute or severe bronchial asthma
- Hypersensitivity to component/class
- Within 2 weeks of MAOI use
- MAOI
- Naltrexone
- Mifepristone
Drug Status
| Availability | Prescription only |
| Pregnancy | Category C |
| Breastfeeding | Can be used but caution in high-risk infants |
| Schedule | Controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Durogesic 25mcg | 4.2mg/patch | Transdermal Patch | 5’s | Janssen Pharma | Janssen Pharma |
| Durogesic 50mcg | 8.4mg/patch | Transdermal Patch | 5’s | Janssen Pharma | Janssen Pharma |
| Fentanyl | 100mcg/2mL | Injection | 5’s | Martindale Pharma | Laborex Kenya |
| Fentanyl | 500mcg/10mL | Injection | 10’s | Martindale Pharma | Laborex Kenya |
| Opifen | 100mcg/2mL | Injection | 5’s | Incepta Pharma | Radiance Pharma |
| Trofentyl | 100mcg/2mL | Injection | 5’s | Troikaa | Harley’s Ltd |
| Trofentyl | 500mcg/10mL | Injection | 5’s | Troikaa | Harley’s Ltd |
| Verfen | 100mcg/2mL | Injection | 10’s | M/S Verve Human Care | Generics Africa |