Respiratory failure due to the combined effects of transdermal fentanyl and epidural bupivacaine/diamorphine following radical nephrectomy.
case_report · Level V
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- Record sourced from PubMed, PMID 11018339.
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Abstract
The transdermal therapeutic system (TTS) fentanyl has been designed for rate-controlled drug delivery. When the system is applied, a fentanyl depot concentrates in the upper skin layers. Plasma concentrations are not measurable until 2 hours after application, and it takes an 8-16 hr latency period until full clinical fentany effects are observed. Following removal, serum fentanyl concentrations decline gradually and fall to about 50% in approximately 16 hours. We report the case of a 77-year-old man with a history of severe arthritis, who was receiving transdermal fentanyl and developed respiratory failure after starting epidural diamorphine/bupivacaine for postoperative pain relief following radical nephrectomy.
Medical subject headings
- Analgesics, Opioid
- Anesthetics, Local
- Bupivacaine
- Fentanyl
- Heroin
- Nephrectomy
- Postoperative Care
- Respiratory Insufficiency