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Intranasal fentanyl and intravenous morphine did not differ for pain relief in children with closed long-bone fractures

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M Borland

M Borland, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia; [email protected]

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, …

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