That pain is a serious clinical problem, which requiresconsiderable effortsby physicians and the nursing staff,has been stressed in numerous publications. Transdermalapplication is well known for a variety of drugs, includingcardiovascular drugs, antiemetics and hormones. Some yearsago, first experience was also made with transdermallyadministered opiates from which the transdermal therapeuticsystem (TTS) fentanyl has now been approved by the AmericanFood and Drug Administration.The book presents the results of the first internationalworkshop "Transdermal Fentanyl", held September 27 -28,1990 in Cologne, FRG. This workshop was intended tofacilitate a critical evaluation of theoretical and clinicalstudies with the new, non-invasive fentanyl application andto provide an opportunity for an exchange of ideas about itsvalue for pain management, anaesthesiology and futureinvestigations in this field. Topics covered by the book arephysiology of transdermal permeation, experience with othertransdermal systems, the present state of acute and chronicpain management and experimental and clinical studies withtransdermal fentanyl, with special concern to analgesicefficacy and side effects.Readers will easily find out that the experts appreciatedtransdermal analgesia but also warned against an uncriticaloptimism. TTS fentanyl can be a valuable tool in theclinicians' armentarium against pain. It should be kept inmind, however, that it represents a new administration mode,not a new drug, and that the sustained, non-invasiveapplication requires well reflected diagnosis and goodgeneral standards of pain management.

I Transdermal Therapeutic Systems - An Introduction

Transdermal Permeation: Physiological and Physicochemical Aspects
Transdermal Therapeutic Systems in Clinical Use: Development and Applications
II Current Aspects of Pain Management
Postoperative Pain
Cancer Pain
Pain Management and Quality of Life in Cancer Patients
Opioid Analgesia for Chronic, Nonmalignant Pain
III Noninvasive Fentanyl Application
Pharmacokinetics of Fentanyl
Premedication and Pain Management with Oral Transmucosal Fentanyl
Transdermal Fentanyl: an Overview of Pharmacokinetics, Efficacy and Safety
IV Postoperative Pain Management with TTS Fentanyl
Pharmacokinetics and Pharmacodynamics
Clinical Experience
Respiratory Safety
TTS Fentanyl in Combination with Patient-Controlled Analgesia
V Cancer Pain Management with TTS Fentanyl
Clinical Experience
VI Other Transdermal Therapeutic Systems for Anesthesia and Pain Management
Local Anesthetics: Eutectic Mixture of Local Anesthetics
Scopolamine.