VIENNA, AustriaManagement of breakthrough pain can sometimes be
problematic in patients who are using transdermal fentanyl
(Duragesic) as an alternative to morphine. Odette Spruyt, MD,
reported at the 9th World Congress on Pain that sufentanil (Sufenta)
used sublingually may help solve this problem. Dr. Spruyt is in the
Palliative Care Service, Peter MacCallum Cancer Institute, East
Melbourne, Victoria, Australia.
The researchers reviewed results in 16 patients with bone-related
cancer pain taking sublingual doses of parenteral sufentanil at 250
µg/5 mL for breakthrough pain. Most patients were using the
fentanyl patch. Two were receiving subcutaneous sufentanil infusions.
Doses of sublingual sufentanil ranged from 5 µg to 40 µg
given up to every 2 hours. Dr. Spruyt said that the sublingual dose
was generally effective and well tolerated. One patient discontinued
it because sufentanil was not readily available in the community
Sublingual parenteral sufentanil provides a simple and
effective option, and may be especially useful for outpatient
management, Dr. Spruyt said. Development of more suitable
formulations of sufentanil for sublingual/transmucosal absorption
would be useful.