Analgesic supplement in general or regional anesthesia.Analgesic action of short duration during anesthesia and immediate postoperative period.Fentanyl is a potent opioid analgesic that increases pain threshold, alters pain reception and inhibits ascending pain pathways by binding to stereospecific receptors within the CNS.May use up to 3 units sequentially, if needed. With each activation, 40 mcg delivered over 10 min. Buccal tablets: Initially, 100-mcg tablet placed between cheek and gum for 14–25 min may be repeated in 30 min if needed.Actiq should be sucked slowly over 15 min. If more than four lozenges are needed daily, increase the dosage of long-acting opioid. Can consider increasing dose if requiring more than one lozenge for treatment of several consecutive breakthrough pain episodes. No more than two lozenges should be used for each breakthrough pain episode. Redosing may start 15 min after the previous lozenge has been completed. Until appropriate dose is reached, an additional dose can be used to treat an episode of breakthrough pain. Actiq: Place unit in mouth between cheek and lower gum.Apply to nonirritated and nonirradiated skin on a flat surface of the upper torso may require replacement in 72 hr if pain has not subsided do not use torn or damaged systems, serious overdose can occur. Initiate therapy with 25 mcg/hr system adjust dose as needed and tolerated.Postoperatively: 50–100 mcg IM for the control of pain, tachypnea, or emergence delirium repeat in 1–2 hr if needed.Adjunct to regional anesthesia: 500–100 mcg IM or slowly IV over 1–2 min.With oxygen for anesthesia: Total high dose is 20–50 mcg/kg IV.Maintenance dose, 2–20 mcg IV or IM when changes in vital signs indicate surgical stress or lightening of analgesia. Adjunct to general anesthesia: Initial dosage is 2 mcg/kg.Premedication: 50–100 mcg IM 30–60 min before surgery.
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