THERAPEUTICS
Intranasal fentanyl and intravenous morphine did not differ for pain relief in children with closed long-bone fractures
In children presenting to the emergency department (ED) with acute long-bone fractures, is intranasal fentanyl equivalent to intravenous (IV) morphine for pain control?
| The first 150 words of the full text of this article appear below. |
Borland M, Jacobs I, King B, et al. A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department. Ann Emerg Med 2007;49:335–40.
Clinical impact ratings Paediatric emergency medicine 
Emergency medicine 
Paediatrics
METHODS
Design:randomised controlled trial.
Allocation:
{concealed}*.
Blinding:
blinded (patients, {clinicians, data collectors, outcome assessors, data analysts, and safety and monitoring committee}*).
Follow-up period:30 minutes after initial analgesic administration.
Setting:tertiary pediatric ED in a hospital in Australia.
Patients:67 patients, 7–15 years of age (mean age 11 y, 79% with radius or ulna fractures), 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, 60 µg)
University of Alberta, Edmonton, Alberta, Canada
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Pain (anaesthesia)
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Drugs: musculoskeletal and joint diseases
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