Nebulized fentanyl vs intravenous morphine for ED patients with acute abdominal pain: a randomized double-blinded, placebo-controlled clinical trial

Deaton, Travis G; Auten, Jonathan D.; Darracq, Michael A.

doi:10.1016/j.ajem.2015.03.046

Cited by 18 publications

(12 citation statements)

References 24 publications

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“…Some studies compared different forms of fentanyl are compared with each other or with morphine. Parallel to our findings, Deaton et al [11] compared the efficacy of IV morphine (0.1 mg/kg) and nebulized fentanyl (2 μg/kg) on the basis of VAS scores at the 10th, 20th, 30th, and 40th minutes and reported that nebulized fentanyl induced significant analgesia at all time intervals. Motamed and Maleki Verki [1] compared intravenous Lidocaine and Fentanyl in RC and showed that the mean for pain severity was not significantly different between fentanyl and P a g e | 608 Comparative effect of Propofol Versus … lidocaine in the different times following administration.…”

Section: Discussionsupporting

confidence: 84%

“…It can be administrated via im, iv (bolus injection, infusion, patient-controlled analgesia), neuroaxial (epidural, intrathecal), transdermal, transmucosal (oral or intranasal) and inhalation routes [9]. It is used as an effective analgesic under emergency conditions [10,11] and has not any side effects such as nausea, dizziness and altered consciousness [11]. It has advantages such as providing a very high level of analgesia and also shows its effect immediately after administration [2].…”

Section: Introductionmentioning

confidence: 99%

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Comparative effect of propofol versus fentanyl in controlling acute renal colic and its hydronephrosis in patients admitted to the hospital

Hayati

Yazdani

Esmaeili

et al. 2020

Eurasian Chem. Commun.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Comparative effect of propofol versus fentanyl in controlling acute renal colic and its hydronephrosis in patients admitted to the hospital

Hayati

Yazdani

Esmaeili

et al. 2020

Eurasian Chem. Commun.

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“…Achieving rapid pain relief is among the most desired factors in patients with displaced fractures presenting at the ED (19). Delay in pain relief by even one minute worsens the medical experience, while it is also associated with potential complications such as increased risk of cardiovascular events (18).…”

Section: Discussionmentioning

confidence: 99%

Intravenous morphine titration vs. oral hydrocodone/acetaminophen for adults with lower extremity displaced fracture in an emergency department setting: A randomized controlled trial

Pan

Wen

et al. 2018

Exp Ther Med

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The objective of the present study was to test the hypothesis that intravenous morphine titration provides superior analgesia to oral hydrocodone/acetaminophen for patients with lower extremity displaced fracture in an emergency department (ED) setting. A prospective, randomized clinical trial of ED patients suffering acute lower extremity displaced fracture pain was performed with a total of 206 participants included. After application of exclusion criteria, the cohort comprised 166 patients, 85 of which were randomly allocated to the oral hydrocodone/acetaminophen (5 mg/500 mg) group and 81 to the intravenous morphine titration (every 5 min by 3-mg increments) group. The main outcome was the visual analogue scale (VAS) at different time-points after the first dose of analgesic was administered. Secondary outcomes included the VAS change during the skeletal traction operation and short-term adverse events. The results demonstrated that the initial VSA of the participants was similar at the baseline on arrival at the ED (P=0.2582). At the time-points of 5, 15, 30 min after the first dose of analgesic administered, the intravenous morphine titration group exhibited a greater VAS reduction compared with that in the oral hydrocodone/acetaminophen group (P<0.01). The differences between the 2 groups were not statistically significant at 1 h or thereafter. The incidence of short-term adverse events was similar between the 2 groups but sedation, whose incidence in the morphine group was markedly increased, may not be arbitrarily attributed to adverse events. It was concluded that, compared with oral hydrocodone/acetaminophen, intravenous morphine titration provided a rapid and sufficient pain relief and equivalent short-term adverse events for patients with lower extremity displaced fracture in an ED setting.

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“…Research has shown 1.5 to 3.0 mcg/kg nebulized fentanyl as effective as IV fentanyl for acute abdominal and musculoskeletal pain in the emergency setting 114 . Research comparing 2 mcg/kg nebulized fentanyl to 0.1 mg/kg IV morphine showed more rapid pain relief, higher patient and physician satisfaction, and similar rates of adverse effects when using fentanyl for acute abdominal pain 1 15 . Though research is limited to the pediatric population, data has shown 1 to 2 mcg/kg intranasal (IN) fentanyl can be used for both safe and effective analgesia in the emergency setting 116 , 117 and may also improve the door-to-analgesia time 118 …”

Section: Opioid Receptor Agonists: Morphine Oxycodone/hydrocodone Fmentioning

confidence: 99%

Essential pharmacologic options for acute pain management in the emergency setting

Cisewski

Motov

2019

Turkish Journal of Emergency Medicine

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Pain is the root cause for the overwhelming majority of emergency department (ED) visits worldwide. However, pain is often undertreated due to inappropriate analgesic dosing and ineffective utilization of available analgesics. It is essential for emergency providers to understand the analgesic armamentarium at their disposal and how it can be used safely and effectively to treat pain of every proportion within the emergency setting. A ‘balanced analgesia’ regimen may be used to treat pain while reducing the overall pharmacologic side effect profile of the combined analgesics. Channels-Enzymes-Receptors Targeted Analgesia (CERTA) is a multimodal analgesic strategy incorporating balanced analgesia by shifting from a system-based to a mechanistic-based approach to pain management that targets the physiologic pathways involved in pain signaling transmission. Targeting individual pain pathways allows for a variety of reduced-dose pharmacologic options – both opioid and non-opioid – to be used in a stepwise progression of analgesic strength as pain advances up the severity scale. By developing a familiarity with the various analgesic options at their disposal, emergency providers may formulate safe, effective, balanced analgesic combinations unique to each emergency pain presentation.

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Nebulized fentanyl vs intravenous morphine for ED patients with acute abdominal pain: a randomized double-blinded, placebo-controlled clinical trial

Cited by 18 publications

References 24 publications

Comparative effect of propofol versus fentanyl in controlling acute renal colic and its hydronephrosis in patients admitted to the hospital

Comparative effect of propofol versus fentanyl in controlling acute renal colic and its hydronephrosis in patients admitted to the hospital

Intravenous morphine titration vs. oral hydrocodone/acetaminophen for adults with lower extremity displaced fracture in an emergency department setting: A randomized controlled trial

Essential pharmacologic options for acute pain management in the emergency setting

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