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

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 ★★★★★★⋆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

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

Embedded ImageFollow-up period:

30 minutes after initial analgesic administration.

Embedded ImageSetting:

tertiary pediatric ED in a hospital in Australia.

Embedded ImagePatients:

67 patients, 7–15 years of age (mean age 11 y, 79% with radius or ulna fractures), who presented to the ED with …

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  • Source of funding: ACEM Morson Taylor Research Grant.