A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting

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Title A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting
Author Rickard, Claire; O'Meara, Peter; McGrail, Matthew; Garner, David; McLean, Alan; Lievre, Peter Le
Journal Name American Journal of Emergency Medicine
Year Published 2007
Place of publication United States
Publisher Elsevier
Abstract Study Objective The objective of the study was to compare intranasal fentanyl (INF) with intravenous morphine (IVM) for prehospital analgesia. Methods This was a randomized, controlled, open-label trial. Consecutive adult patients (n = 258) requiring analgesia (Verbal Rating Score [VRS] >2/10 noncardiac or >5/10 cardiac) were recruited. Patients received INF 180 μg ± 2 doses of 60 μg at ≥5-minute intervals or IVM 2.5 to 5 mg ± 2 doses of 2.5 to 5 mg at ≥5-minute intervals. The end point was the difference in baseline/destination VRS. Results Groups were equivalent (P = not significant) for baseline VRS [mean (SD): INF 8.3 (1.7), IVM 8.1 (1.6)] and minutes to destination [mean (SD): INF 27.2 (15.5), IVM 30.6 (19.1)]. Patients had a mean (95% confidence interval) VRS reduction as follows: INF 4.22 (3.74-4.71), IVM 3.57 (3.10-4.03); P = .08. Higher baseline VRS (P < .001), no methoxyflurane use (P < .01), and back pain (P = .02) predicted VRS reduction. Safety and acceptability were comparable. Conclusions There was no significant difference in the effectiveness of INF and IVM for prehospital analgesia.
Peer Reviewed Yes
Published Yes
Publisher URI http://www.sciencedirect.com/science/journal/07356757
Alternative URI http://dx.doi.org/10.1016/j.ajem.2007.02.027
Copyright Statement Copyright 2007 Elsevier. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
Volume 25
Issue Number 8
Page from 911
Page to 917
ISSN 0735-6757
Date Accessioned 2007-09-14
Date Available 2008-05-16T03:44:46Z
Language en_AU
Research Centre Griffith Health Institute; Centre for Health Practice Innovation
Faculty Griffith Health Faculty
Subject Anaesthesiology; Clinical Nursing: Secondary (Acute Care); Clinical Sciences; Medical and Health Sciences
URI http://hdl.handle.net/10072/18847
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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