The Cognitive Effects of Using Transdermal Fentanyl in Cancer Pain

Abstract

Objectives: In this study, we aimed to investigate of using transdermal fentanyl (TDF) effects to cognitive functions in cancer pain.
Methods: After approval informed consent of patients and Ethical Committee, fifty patients with cancer pain who had no opioid treatments before were included in the study. Pain was evaluated with Visual Analogue Scale (VAS), cognitive functions were assessed using by Addenbrooke’s Cognitive Examination final revised version (ACE-R), performance was evaluated with Eastern Cooperative Oncology Group Performance Status (ECOG), adverse reactions were noted.Patients’ algological evaluation had done in first application and the normal cognitive functions were established using by ACE-R. In cases the treatment was began with 25μg/h TDF and certain stages of the treatment dose was increased so that VAS ≤ 2. ACE-R was applied again on 30. day under enough analgesia. All patients were compared with ACE-R total scores and subgroups ( attention-orientation, memory, fluency, language, visuospatial abilities) at before and after TDF treatment in each other.
Results: At the end of the study, attention-orientation, memory, fluency, language, ACER total scores were statistically significant improvement after the treatment than compared to before. No significant change was obtained in visuospatial abilities. No difference was detected in performance status.
Conclusion: The use of transdermal fentanyl for the treatment of cancer pain are not associated with impairments in cognitive performance, even some cognitive test scores significantly improved. The absence of pain increased the quality of life.