Evid Based Nurs doi:10.1136/ebn1150
  • Pain management
  • Randomised controlled trial

Fentanyl Pectin Nasal Spray reduces breakthrough cancer pain intensity compared with placebo in people taking at least 60 mg daily oral morphine or equivalent

  1. Carol P Curtiss
  1. Tufts University Medical School, Boston, Massachusetts, USA
  1. Correspondence to: Carol P Curtiss
    Master of Science in Pain Research, Education and Policy (MSPREP) Program, 73 James Street, Greenfield, MA 01301, USA; carol. curtiss{at}

Commentary on:

Implications for nursing practice

  • Breakthrough pain is a significant problem for people with cancer.

  • Patterns of breakthrough pain are often different from the pharmacokinetics of immediate release oral analgesics.

  • Matching patterns of breakthrough pain with medications that work within the timeframe of breakthrough pain may improve breakthrough pain management.

  • A comprehensive assessment includes evaluating breakthrough pain separately from persistent pain, using similar strategies for screening and assessing both types of pain.

  • Fentanyl Pectin Nasal Spray (FPNS) provides an additional option to manage breakthrough cancer pain (BTCP).

  • Patient education regarding the correct use of medications for persistent and breakthrough pain and the appropriate use of novel routes of administration is important for optimal analgesic medication efficacy and safety.

Implications for research

  • Additional research on assessing and managing breakthrough pain is important to identify appropriate treatment options.

  • Novel routes of medication administration for breakthrough pain may provide new insight into the management of this distressing and complex type of pain.

  • Research regarding patient adherence and satisfaction with new routes of administration can guide nursing practice and patient education.

  • Research regarding costs, patient access …

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