Administering Pain Reliever by Nasal Spray Is Fast, Flexible
WebMD News Archive
June 22, 2000 -- A new method of fast-acting pain control, in which patients
give themselves doses of a powerful pain reliever with a nasal spray bottle,
shows promise for people with chronic pain as well as those having surgery, a
group of German researchers has found.
The researchers are testing this method for delivery of a short-acting but
strong pain reliever called fentanyl. Researcher Hans Walter Striebel, MD, PhD,
DEAA, tells WebMD that pain relievers like fentanyl are rapidly absorbed
through the nose.
"We found our patients experienced as much pain relief as if they were
taking intravenous medications," says Striebel, a professor of
anesthesiology at the Municipal Hospital Frankfurt-Hochst, the teaching
hospital of the J.W. Goethe University in Frankfurt.
Intravenous (IV) forms of patient-controlled pain medications are already
available. Known as PCA pumps, these devices allow patients to give themselves
another dose of pain medicine whenever they feel like it, rather than waiting
for a nurse to do it. Both the nasal spray device and PCAs have limits, so
patients can never give themselves too much medicine, or too much at one
But PCAs are not always convenient, since the patient must be hooked up to
an IV machine delivering the medication. If the patient is at home, a nurse has
to visit to make sure the PCA stays connected properly. Getting the same kind
of pain relief from a small nasal spray bottle would be much easier.
The German research team tested their new method of pain relief on 48
patients who had just had surgery. Each could use both the nasal spray bottle
and the PCA, so they didn't know which device was administering the actual
medicine. Every few minutes, someone asked them how much pain they were
feeling, and the researchers found that the nasal spray bottle and the PCA
relieved pain equally well. Their study was published in the Canadian
Journal of Anesthesia.
"This new method of pain relief could be used for any chronic pain
patient with sudden flare-ups of severe pain, such as sickle cell and chronic
pancreatitis patients," Jeffrey Wassermann, MD, director of the pain
management clinic at Methodist Medical Center in Dallas, tells WebMD. Wasserman
was not involved in the research.
James Crews, MD, an associate professor of anesthesiology at Wake Forest
University School of Medicine in Winston-Salem, N.C., agrees. He adds that the
nasal spray devices could be used to give extra relief to cancer patients who
are already using slow-acting pain relievers such as morphine. "They could
also be useful for AIDS-related pain," Crews says. "They could help
patients doing physical therapy or respiratory therapy who have
movement-associated pain and need a little boost."
In fact, the Frankfurt research team has already done studies using these
methods to control this so-called breakthrough pain in home-based cancer
patients, for weeks and months, with very good results, Striebel says. Soon,
they'll begin testing the method in children, who are often afraid of
Striebel says the results from the current research are very promising.
Right now, the nasal spray device is only available in clinical studies, but he
hopes that within two to three years they will be available to all pain