Intranasal fentanyl and intravenous morphine did not differ for pain relief in children with closed long-bone fractures
M Borland
M Borland, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia; meredith.borland@health.wa.gov.au
QUESTION
In children presenting to the emergency department (ED) with acute long-bone fractures, is intranasal fentanyl equivalent to intravenous (IV) morphine for pain control?
METHODS
Design:
randomised controlled trial.
Allocation:
{concealed}.*
Blinding:
blinded (patients, {clinicians, data collectors, outcome assessors, data analysts, and monitoring committee}*).
Follow-up period:
30 minutes after initial analgesic administration.
Setting:
tertiary paediatric ED in a hospital in Australia.
Patients:
67 patients 7–15 years of age (mean age 11 y, 79% with fractures of the radius or ulna), who presented to the ED with clinically deformed, closed, long-bone fractures. Exclusion criteria were narcotic analgesia within 4 hours of arrival, significant head injury, allergy to opiates, nasal blockage or trauma, and inability to perform pain scoring.
Intervention:
33 patients were given intranasal fentanyl (weight-determined initial dose: 21–30 kg, 30 µg; 31–40 kg, 45 µg; 41–50 kg, …
