PMID- 21175512
OWN - NLM
STAT- MEDLINE
DCOM- 20111014
LR  - 20220408
IS  - 1553-2712 (Electronic)
IS  - 1069-6563 (Linking)
VI  - 17
IP  - 11
DP  - 2010 Nov
TI  - Use of intranasal fentanyl for the relief of pediatric orthopedic trauma pain.
PG  - 1155-61
LID - 10.1111/j.1553-2712.2010.00905.x [doi]
AB  - OBJECTIVES: The objective was to evaluate the use of a single 2 mug/kg dose of 
      intranasal fentanyl as analgesia for painful orthopedic injuries in children 
      presenting to a pediatric emergency department (ED). METHODS: This was a 
      prospective, nonblinded interventional trial, in a convenience sample of patients 
      3 to 18 years of age seen in a tertiary care pediatric ED. All had clinically 
      suspected fractures and were treated between July and November 2006. Eligible 
      patients had moderate to severe pain based on initial pain scores using the Wong 
      Baker Faces Scale (WBS) for patients aged 3-8 years or the Visual Analog Scale 
      (VAS) for patients aged 9-18 years. All enrolled patients received fentanyl via 
      intranasal atomization. Pain scores were obtained at baseline and at 10, 20, and 
      30 minutes after intranasal fentanyl administration. Satisfaction scores were 
      obtained using a 100-mm VAS. Vital signs and adverse events were recorded. 
      RESULTS: Eighty-one patients were enrolled, 28 in the VAS group and 53 in the WBS 
      group. The mean patient age was 8 years. Fracture locations included forearm, 38 
      (47%); supracondylar, 16 (20%); clavicle, 7 (9%); tibia/fibula, 5 (6%); and 
      other, 15 (18%). In the WBS group, the median pain scores decreased from five 
      faces (interquartile range [IQR] = 4-6) at baseline to three faces (IQR = 2-5) at 
      10 minutes, two faces (IQR = 1-4) at 20 minutes, and two faces (IQR = 1-3) at 30 
      minutes. The mean pain score in the VAS group at baseline was 70 mm (95% 
      confidence interval [CI] = 63 to 77 mm). In this group, the pain scores decreased 
      by a mean of 21 mm (95% CI = 14 to 28 mm) at 10 minutes, 25 mm (95% CI = 15 to 34 
      mm) at 20 minutes, and 27 mm (95% CI = 16 to 37 mm) at 30 minutes. Mean 
      satisfaction scores were 79 mm for providers, 74 mm for parents, and 62 mm for 
      patients. No adverse events were recorded. CONCLUSIONS:   Intranasal fentanyl at 
      a dose of 2 mug/kg provides effective analgesia for pediatric ED patients with 
      painful orthopedic trauma within 10 minutes of administration.
CI  - (c) 2010 by the Society for Academic Emergency Medicine.
FAU - Saunders, Mary
AU  - Saunders M
AD  - Department of Pediatric Emergency Medicine, Medical College of Wisconsin, 
      Milwaukee, USA. mary.saunders@yahoo.com
FAU - Adelgais, Kathleen
AU  - Adelgais K
FAU - Nelson, Douglas
AU  - Nelson D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Acad Emerg Med
JT  - Academic emergency medicine : official journal of the Society for Academic 
      Emergency Medicine
JID - 9418450
RN  - 0 (Analgesics, Opioid)
RN  - UF599785JZ (Fentanyl)
SB  - IM
MH  - Administration, Intranasal
MH  - Adolescent
MH  - Analgesics, Opioid/administration & dosage/*pharmacology/standards
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fentanyl/administration & dosage/*pharmacology/standards
MH  - Fractures, Bone/*complications
MH  - Humans
MH  - Male
MH  - Orthopedics
MH  - Pain/*complications/*drug therapy
MH  - Pain Measurement
MH  - Patient Satisfaction
MH  - Pediatrics
EDAT- 2010/12/24 06:00
MHDA- 2011/10/15 06:00
CRDT- 2010/12/24 06:00
PHST- 2010/12/24 06:00 [entrez]
PHST- 2010/12/24 06:00 [pubmed]
PHST- 2011/10/15 06:00 [medline]
AID - 10.1111/j.1553-2712.2010.00905.x [doi]
PST - ppublish
SO  - Acad Emerg Med. 2010 Nov;17(11):1155-61. doi: 10.1111/j.1553-2712.2010.00905.x.