Fentanyl Plasma Concentrations after Application of a Transdermal Patch in Three Different Locations to Refine Postoperative Pain Management in Rabbits

Abstract

Transdermal patches allow a noninvasive and "stress free" analgesia in rabbits. As fentanyl uptake is dependent on exogenous and endogenous factors of the area where the patch is applied, this study investigated three different locations (neck, inner and outer surfaces of the ear) for fentanyl patch application to provide adequate and reliable fentanyl plasma concentrations above those previously shown to be analgesic. Fentanyl plasma concentration was measured at different time points (3, 6, 9, 12, 18, 24, 36, 48, 72, 96, 120 h) and rabbits were assessed for their general conditions and treatment-related side effects. Practicability of the proposed methods was evaluated. Following patch application on the neck, fentanyl plasma concentrations equal to or above the analgesic value were measured in all rabbits between 6 and 72 h. Comparable concentrations were reached between 9 and 48 h in all animals for the outer ear surface. However, for the inner ear surface, analgesic concentrations were not reached, even if practicability was considered the best for this location. Preparation of the neck skin was judged as the most cumbersome due to the clipping of the dense fur and patch removal resulted in erythema. In summary, the application of the fentanyl patch on the neck and outer ear surface allowed the reach of reliable plasma concentrations above the analgesic threshold in rabbits. When applied on the neck, fentanyl patches provided the longest duration of analgesic plasma concentrations, whereas patch application and removal were easier on the outer ear surface.

Keywords: postoperative analgesia; rabbit; refinement; transdermal fentanyl patch.

Figure 1

Study design. Fentanyl plasma concentrations higher than 0.5 ng/mL were considered to be analgesic based on previous reports [13,19]. Outcome parameters were time spent above threshold concentration, variability of fentanyl plasma concentrations and practicability of patch application.

Figure 2

Fentanyl plasma concentrations group 1 (outer surface of the ear).

Figure 3

Fentanyl plasma concentrations group 3 (neck).

Figure 4

Fentanyl plasma concentrations group 2 (inner surface of the ear).

Figure 5

Fentanyl plasma concentrations of all groups.

Figure 6

Representative images of skin condition after patch removal (left: group 1, middle: group 2 and right: group 3).