What's the deal with Fentanyl acute or chronic pain?

Our Potter and Perry nursing text and my Davis drug guide talk about how Fentanyl is used for chronic, but not acute pain. However, my wife who works on an acute care floor at Clarion routinely gives the stuff for post-op, acute care type clients. Are my books and instructors out of date or are the Doc's using the drug "off label". Davis specifically indicates on page 417 (9th edition) that the drug is contraindicated in acute or postoperative situations.

[begalli]

Our narc of choice in the ICU is fentanyl. We rarely have morphine drips. When we do use morphine, it's almost always for end of life care - it's our protocol but some docs order fentanyl instead. Same with boluses fentanyl > morphine.

Also, we usually use dilaudid for epidural basal and fentanyl for the PCEA. And always fentanyl for PCA.

Does that make sense?!

[BittyBabyGrower, MSN, RN]

We use Fent much more than morphine too.

[rnmi2004]

Is your book possibly referring to the Fentanyl patch? This is often used for chronic pain patients. Fentanyl IVP is used for acute pain.

[Tweety, BSN, RN]

Is your book possibly referring to the Fentanyl patch? This is often used for chronic pain patients. Fentanyl IVP is used for acute pain.

That's just what I was going to say. It's both.

[rjflyn, ASN, RN]

See it used alot in EMS systems as well. Reason being is its short half-life. Medics can give a patient pain relief and it wears off so a surgeon can do an exam a couple hours later after they have been worked up in the ER.

rj

[MacERRN]

We use it, IV fentanyl, in the ER as a analgesic during conscious sedation for orthopedic procedures like closed reductions of fractures,or dislocation. It is prefered over morphine for reasons already stated, plus it has a quicker onset than morphine.