Alfentanil is used for
chronic pain relief in
palliative care. However, there is a dearth of data on its use. For this reason, a decision was made to review the use of
alfentanil in
palliative care. Retrospective study was carried out in a
palliative care service. The files of patients who received
alfentanil as an intravenous or subcutaneous continuous infusion for
pain relief, between January 2018 and April 2019. In total, 111 patients received
alfentanil out of 113 admissions. Of them, 56 were male, and the median age was 70 years. The median number of days on
alfentanil was 6 (range 1 to 129). The most frequent primary reasons for switching to
alfentanil was uncontrolled
pain in 52 (46%) patients and renal impairment in 24 (21%) patients. The median 24-h initial dose of
alfentanil was 4 mg (1-20), and the median final 24-h dose of
alfentanil was 5 mg (1-60), (p < 0.001). The initial 24-h median number of rescue doses was 2 (0-8), and the final median number of rescue doses was 1 (0 to 8), (p = 0.025). In 56 patients who were on
alfentanil for at least 7 days, the dose decreased in 3 (5%), remained stable in 10 (18%) and increased in 43 (77%). The patient on
alfentanil for 129 days maintained the same dose throughout that period.
Alfentanil can be a useful second-line
opioid. The induction of tolerance does not seem to be particularly rapid with
alfentanil.