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I do not have personal experience with your issue, but, I did make inquiry of my hospital oncology pharmacist.
His reply was as follows:
Respiratory depression will potentially be a greater risk in patients with compromised respiratory function. I don't think there is anything extra special about Fentanyl vs other opioids though but I don't remember ever using it in Lung Ca patients. We tend to use an epidural post op in the pneumonectomy/lobectomy patients rather than a PCA though.
We are both from a large hospital in Brisbane, Australia with Thoracic Oncology specialty.
Hope this helps.
Hi
Fentanyl can cause muscle rigidity as well as hypoventilation because of its central effects see attached blurb from Micromedex.
Gareth
) Muscular rigidity can occur following rapid administration of intravenous fentanyl, causing CHEST WALL SPASM (Waller et al, 1981a; Comstock et al, 1979a); (DeLange et al, 1982)(AMA Division of Drugs, 1983). POSTOPERATIVE RIGIDITY has also been observed (Christian et al, 1983). TRUNCAL RIGIDITY also occurs with other narcotic analgesics (Freund et al, 1973; Grell et al, 1970). Fentanyl-induced rigidity in human volunteers was observed approximately 3 minutes after peak plasma concentration of fentanyl was reached and lasted between 7 and 23 minutes. Additionally, unconsciousness occurred simultaneously with muscle rigidity (Streisand et al, 1993).
b) Fentanyl may cause muscular rigidity, especially those involving respiration. Movement of various skeletal muscles groups of the extremities, neck, and external eye have been reported during induction with fentanyl anesthesia; rarely have these movements been strong enough to pose patient management problems. This effect is related to the dose and the rate of administration and the incidence may be reduced by: 1) administering up to 1/4 of the full paralyzing dose of a non-depolarizing neuromuscular blocking agent just prior to the administration of fentanyl; 2) administering the full paralyzing dose of a neuromuscular blocking agent follow the loss of the eyelash reflex when fentanyl is used in anesthetic doses titrated by slow intravenous infusion; 3) simultaneous administration of fentanyl and full paralyzing dose of a neuromuscular blocking agent, when fentanyl is used in rapidly administered anesthetic doses. The neuromuscular blocking agent chosen should be compatible with the patient's cardiovascular status (Prod Info Sublimaze(R), 98b).
ya even i had come accross people who had been effected with lung cancer.And what i came to know is most of the effected people were chain smokers.And some of them got due to pollution.So my suggesstion is smoking must be banned, as the people who don't smoke are also effected.
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julia smith
Edited: Aug 23, 2008 @ 9.40am