Pain management is a specialty fraught with potential problems, all of which can negatively impact outcomes and therefore diminish the overall efficacy of the initial surgery.
Where pain is managed by injection or medical therapies, there are serious risks that patients may not correctly follow the instructions for the administration of their drugs, either over- or under-dosing, or incurring needle-stick injuries or infections as a consequence. There are other more obvious risks such as dislodging catheters or knocking over IV pump stands.
These risks are customarily managed by using qualified care-givers to administer the drugs, which is a waste of their time, expensive and intrusive for the patient.
In January 2008, Johnson & Johnson subsidiary Janssen-Cilag International NV announced the availability of its new product IONSYS™, a needle-free product for the management of acute post-operative pain. Initially available only in Germany, the UK and Ireland, it will be launched in all other EU states in the near future.
IONSYS™ is a patient-activated, fentanyl iontophoretic transdermal system, which has been demonstrated to be as effective as IV PCA morphine for acute, post-operative pain management.
The lightweight, self-contained system is adhesively attached to the patient’s upper arm or chest and, when activated, uses a low-intensity electrical field to transport fentanyl through the skin and into the bloodstream (i.e. iontophoresis – developed by ALZA Corporation, an affiliate of Janssen-Cilag).
The system automatically delivers up to six 40-mcg doses of fentanyl per hour up to a maximum of 80 doses during 24 hours. It shuts down automatically after the maximum number of doses has been administered or the 24-hour period has ended, and is designed for safe disposal. This pre-programming eliminates the risk of incorrect dosage and the absence of needles or other paraphernalia eliminates the other main risks of traditional pain management delivery systems.
Unfortunately, it cannot eliminate the risks of side effects common to all other opioids.