Effectiveness of Intranasal Analgesia in the Emergency Department

Abstract

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.

Intranasale Schmerzmittel in der Notfallmedizin – Was ist die Evidenz? Teil 2 Esketamin

“…Daten für Patienten unter 18 Jahren liegen aus diesen Studien nicht vor [5,23]. In diesen Studien traten leichte Nebenwirkungen wie Schwindel, Übelkeit, Erbrechen kurzzeitiger Blutdruckabfall, Verwirrtheit, Agitation auf, die jedoch keine Intervention erforderten [24,25] [11]. Die Risiken der Off-Label-Anwendung als Analgetikum sowie mögliche haftungsrechtliche Konsequenzen bei auftretenden Schäden sind jedoch zu beachten [39].…”

Editorial for the Special Issue “Emergency Medicine and Emergency Room Medical Issues II”

“…Of course, bleeding treatment strategies also occupy a relevant place in research conducted by scholars around the world. The evaluation of the Hitit Index in differential diagnosis of Crimean-Congo hemorrhagic fever in the emergency department [7], the effectiveness of intranasal analgesia in the emergency room [8], and the use of Aflibercept for gastrointestinal bleeding in Hereditary Hemorrhagic Telangiectasia [9] were described.…”

Quetamina Como Modalidade Terapêutica Para Enxaqueca E Cefaléia Tensional: Uma Revisão De Literatura

“…Esta última via com destaque, tendo em vista seu perfil de segurança, curto período para início de ação e a facilidade para sua realização (ZANZA; SAGLIETTI;GIAMELLO;SAVIOLI et al, 2023). Entre as várias vantagens do uso clínico da quetamina no contexto da dor crônica, é observável, também, o seu atributo de não gerar instabilidade respiratória e hemodinâmica (ZANZA; SAGLIETTI;GIAMELLO;SAVIOLI et al, 2023).Nesse contexto, estudos têm sido realizados sobre o uso da quetamina para enxaqueca e cefaléia, que já iniciaram há cerca de 20 anos (BILHIMER; GROTH; HOLMES, 2020).Quetamina e cefaleia: uma nova abordagem terapêutica Vários estudos que avaliaram os efeitos da quetamina na cefaleia vieram do ambiente do pronto-socorro, porém poucos se concentraram na cefaleia refratária (MOJICA; SCHWENK; LAURITSEN; NAHAS, 2021). Em uma revisão de literatura, foi visto que a quetamina no departamento de emergência para o manejo da enxaqueca possui evidência limitada ou inconsistente (ROBBLEE; GRIMSRUD, 2020).…”