Transdermal Fentanyl patch: An approach to enhance tolerance of conscious proning in COVID-19 patients

Authors

  • Sowmia Mammen, MBBS, DNB
  • Beena Yousuf, MBBS, FCPS
  • Mohammad Shamsah, MBBS, FRCPC

DOI:

https://doi.org/10.5055/jom.2020.0576

Keywords:

Transdermal fentanyl patch, concious proning, COVID-19, tolerance, enhance

Abstract

The COVID-19 ARDS appears to have worse outcomes than ARDS from other causes. It is a predictable serious complication and the key strategy is to maintain oxygenation. Adopting the prone position for conscious COVID-19 patients requiring basic respiratory support, is shown to benefit patients in terms of improving oxygenation, reducing the need for invasive ventilation and potentially even reducing mortality. Cough and myalgia are the common and most distressing symptoms seen in conscious COVID-19 patients which can impair tolerance to awake proning. Modified awake proning with application of transdermal fentanyl patch (TFP) can improve the compliance to conscious proning in COVID-19 patients.

Author Biographies

Sowmia Mammen, MBBS, DNB

DNB (Anaestheia), Registrar, Department of Anaesthesia, Critical Care and Pain Management, Al Adan Hospital, Ministry of Health, Kuwait

Beena Yousuf, MBBS, FCPS

Specialist, Department of Anaesthesia, Critical Care and Pain Management, Al Adan Hospital, Ministry of Health, Kuwait

Mohammad Shamsah, MBBS, FRCPC

Consultant, Department of Anaesthesia, Critical Care and Pain Management, Al Adan Hospital, Ministry of Health, Kuwait

References

Gibson PG, Qin L, Puah S: COVID-19 ARDS: Clinical features and differences to “usual” pre-COVID ARDS. Med J Aust. 2020; [Preprint, 24 April 2020].

Scholten E, Beitler J, Prisk G, et al.: Treatment of ARDS With Prone Positioning. Chest. 2017; 151(1): 215-224. DOI: 10.1016/j.chest.2016.06.032.

Ding L, Wang L, Ma W, et al.: Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: A multi-center prospective cohort study. Crit Care. 2020; 24: 28. DOI:10.1186/s13054-020-2738-5.

Sun Q, Qiu H, Huang M, et al.: Lower mortality of COVID-19 by early recognition and intervention: Experience from Jiangsu Province. Annals of Intensive Care. 2020; 10(1). DOI: 10.1186/s13613-020-00650-2.

Dondorp A, Hayat M, Aryal D, et al.: Respiratory support in novel coronavirus disease (COVID-19) patients, with focus on resource limited settings. Am J Trop Med Hyg. 2020: 102(6): 1191-1197. DOI: 10.4269/ajtmh.20-0283.

JAJ Martyn, Mao J, Bittner EA: Opioid tolerance in critical illness. N Engl J Med. 2019; 380: 365-378. DOI: 10.1056/NEJMra1800222.

Kelly HE, Shaw GM, Brett CN, et al.: The effect of titrated fentanyl on suppressed cough reflex in healthy adult volunteers. Anesthesia. 2016; 71(5): 529-534. DOI:10.1111/anae.13410.

Lippi G: Myalgia may not be associated with severity of coronavirus disease 2019 (COVID-19). World J Emer Med. 2020; 11(3): 140. DOI:10.5847/wjem.j.1920-8642.2020.03.013.

Li LQ, Huang T, Wang YQ, et al.: COVID-19 patient’s clinical characteristics, discharge rate and fatality rate of meta-analysis. J Med Virol. 2020; 92: 577-583. DOI:10.1002/jmv.25757.

Sathitkarnmanee T, Tribuddharat S, Noiphitak K, et al.: Transdermal fentanyl patch for postoperative analgesia in total knee arthroplasty: a randomized double-blind controlled trial. J Pain Res. 2014; 7: 449-454. DOI:10.2147/JPR.S66741.

Slessarev M, Cheng J, Ondrejicka M, et al.: Patient self-proning with high-flow nasal cannula improves oxygenation in COVID-19 pneumonia. Canadian J Anesth/J Canadien Anesth. 2020. DOI: 10.1007/s12630-020-01661-0.

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Published

07/01/2020

How to Cite

Mammen, MBBS, DNB, S., B. Yousuf, MBBS, FCPS, and M. Shamsah, MBBS, FRCPC. “Transdermal Fentanyl Patch: An Approach to Enhance Tolerance of Conscious Proning in COVID-19 Patients”. Journal of Opioid Management, vol. 16, no. 4, July 2020, pp. 237-8, doi:10.5055/jom.2020.0576.

Issue

Section

Editorial