Evid Based Nurs 11:42 doi:10.1136/ebn.11.2.42
  • Treatment

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;


In children presenting to the emergency department (ED) with acute long-bone fractures, is intranasal fentanyl equivalent to intravenous (IV) morphine for pain control?



randomised controlled trial.




blinded (patients, {clinicians, data collectors, outcome assessors, data analysts, and monitoring committee}*).

Follow-up period:

30 minutes after initial analgesic administration.


tertiary paediatric ED in a hospital in Australia.


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.


33 patients were given intranasal fentanyl (weight-determined initial dose: 21–30 kg, 30 µg; 31–40 kg, 45 µg; 41–50 kg, …

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