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Oral Transmucosal Fentanyl Pretreatment

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Oral Transmucosal Fentanyl Pretreatment
Clinical onset of sedation following OTFC administration was found to occur within 10-20 minutes.
Monitoring clinical onset of sedation is advantageous because it permits the anesthesia care provider to remove the unused lozenge and to avoid potential oversedation.
This attribute distinguishes OTFC from an injection or an oral sedative, where none of the drug dose can be recovered after administration.

The children in both the placebo and active treatment groups had improved sedation scores in the waiting room.
Although this was not a statistically significant finding, it does suggest that there is a benefit to establishing a positive relationship between child and provider.
The use of either the placebo or active lozenge provides a favorable experience by soothing and quieting the child.
As one might expect, this level of placebo sedation did not improve separation ratings as dramatically as in the fentanyl group.

Providing safe and effective premedication in pediatric dentistry has been a challenging issue for decades.
Similar to previous reports, we found the OTFC to be well accepted by most of our young patients.
Only two children in the current study refused to cooperate with the dentist anesthesiologist and accept the use of the formulation.
However, uncooperative children can potentially cause a sedation failure with any premedication administered by the oral route.
It is imperative for dental practitioners to have an alternative plan to manage a child’s anesthetic needs when patient acceptance is absent.

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