PMID- 37893464
OWN - NLM
STAT- MEDLINE
DCOM- 20231030
LR  - 20231031
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 59
IP  - 10
DP  - 2023 Sep 29
TI  - Effectiveness of Intranasal Analgesia in the Emergency Department.
LID - 10.3390/medicina59101746 [doi]
LID - 1746
AB  - In the Emergency Department (ED), pain is one of the symptoms that are most 
      frequently reported, making it one of the most significant issues for the 
      emergency physician, but it is frequently under-treated. Intravenous (IV), oral 
      (PO), and intramuscular (IM) delivery are the standard methods for administering 
      acute pain relief. Firstly, we compared the safety and efficacy of IN analgesia 
      to other conventional routes of analgesia to assess if IN analgesia may be an 
      alternative for the management of acute pain in ED. Secondly, we analyzed the 
      incidence and severity of adverse events (AEs) and rescue analgesia required. We 
      performed a narrative review-based keywords in Pubmed/Medline, Scopus, EMBASE, 
      the Cochrane Library, and Controlled Trials Register, finding only twenty 
      randomized Clinical trials eligible in the timeline 1992-2022. A total of 2098 
      patients were analyzed and compared to intravenous analgesia, showing no 
      statistical difference in adverse effects. In addition, intranasal analgesia also 
      has a rapid onset and quick absorption. Fentanyl and ketamine are two intranasal 
      drugs that appear promising and may be taken simply and safely while providing 
      effective pain relief. Intravenous is simple to administer, non-invasive, rapid 
      onset, and quick absorption; it might be a viable choice in a variety of 
      situations to reduce patient suffering or delays in pain management.
FAU - Zanza, Christian
AU  - Zanza C
AD  - Italian Society of Prehospital Emergency Medicine-SIS 118-Taranto, 74121 Taranto, 
      Italy.
AD  - Post Graduate School of Geriatric Medicine, University of Rome "Tor Vergata", 
      00133 Rome, Italy.
FAU - Saglietti, Francesco
AU  - Saglietti F
AUID- ORCID: 0000-0002-8767-6577
AD  - Department of Anesthesia and Critical Care, Santa Croce and Carle Hospital, 12100 
      Cuneo, Italy.
FAU - Giamello, Jacopo Davide
AU  - Giamello JD
AUID- ORCID: 0000-0002-5085-3074
AD  - Emergency Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy.
FAU - Savioli, Gabriele
AU  - Savioli G
AUID- ORCID: 0000-0002-8679-5435
AD  - Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 
      Pavia, Italy.
FAU - Biancone, Davide Maria
AU  - Biancone DM
AD  - Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy.
FAU - Balzanelli, Mario Giosue
AU  - Balzanelli MG
AD  - Italian Society of Prehospital Emergency Medicine-SIS 118-Taranto, 74121 Taranto, 
      Italy.
FAU - Giordano, Benedetta
AU  - Giordano B
AD  - Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy.
FAU - Trompeo, Anna Chiara
AU  - Trompeo AC
AD  - Department of Anesthesia and Critical Care, AOU Citta della Scienza e della 
      Salute, 10126 Torino, Italy.
FAU - Longhitano, Yaroslava
AU  - Longhitano Y
AUID- ORCID: 0000-0001-8831-1361
AD  - Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh 
      Medical Center, Pittsburgh, PA 15260, USA.
AD  - Department of Emergency Medicine, Humanitas University, 20089 Milan, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230929
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Humans
MH  - Pain Management/methods
MH  - *Acute Pain/diagnosis
MH  - Analgesics, Opioid/therapeutic use
MH  - *Analgesia/methods
MH  - Emergency Service, Hospital
PMC - PMC10608673
OTO - NOTNLM
OT  - acute pain management
OT  - analgesics
OT  - emergency department
OT  - fentanyl
OT  - intranasal administration
OT  - ketamine
OT  - ketorolac
OT  - migraine
OT  - nsaid
OT  - pain
OT  - paracetamol
OT  - primary headache disorder
COIS- The authors declare no conflict of interest.
EDAT- 2023/10/28 11:46
MHDA- 2023/10/30 06:46
PMCR- 2023/09/29
CRDT- 2023/10/28 01:10
PHST- 2023/08/23 00:00 [received]
PHST- 2023/09/23 00:00 [revised]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2023/10/30 06:46 [medline]
PHST- 2023/10/28 11:46 [pubmed]
PHST- 2023/10/28 01:10 [entrez]
PHST- 2023/09/29 00:00 [pmc-release]
AID - medicina59101746 [pii]
AID - medicina-59-01746 [pii]
AID - 10.3390/medicina59101746 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2023 Sep 29;59(10):1746. doi: 10.3390/medicina59101746.