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

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

https://doi.org/10.1136/ebn.11.2.42

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    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, …

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    Footnotes

    • Source of funding: ACEM Morson Taylor Research Grant.