Intranasal fentanyl is an equivalent analgesic to oral morphine in paediatric burns patients for dressing changes: A randomised double blind crossover study

Borland, M. L., Bergesio, R., Pascoe, E. M., Turner, S. and Woodger, S. (2005) Intranasal fentanyl is an equivalent analgesic to oral morphine in paediatric burns patients for dressing changes: A randomised double blind crossover study. Burns, 31 7: 831-837. doi:10.1016/j.burns.2005.05.001


Author Borland, M. L.
Bergesio, R.
Pascoe, E. M.
Turner, S.
Woodger, S.
Title Intranasal fentanyl is an equivalent analgesic to oral morphine in paediatric burns patients for dressing changes: A randomised double blind crossover study
Journal name Burns   Check publisher's open access policy
ISSN 0305-4179
1879-1409
Publication date 2005-11
Sub-type Article (original research)
DOI 10.1016/j.burns.2005.05.001
Volume 31
Issue 7
Start page 831
End page 837
Total pages 7
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon
Language eng
Formatted abstract
Introduction: The ideal analgesic agent for burns wound dressings in paediatric patients would be one that is easy to administer, well tolerated, and produces rapid onset of analgesia with a short duration of action and minimal side-effects to allow rapid resumption of activities and oral intake. We compared our current treatment of oral morphine to intranasal fentanyl in an attempt to find an agent closer to the ideal.
Methods: A randomised double blind two-treatment crossover study comparing intranasal administration of fentanyl (INF) to orally administered morphine (OM). Children with burn injury aged up to 15 years and weighing 10–75 kg were included. Primary end-point was pain scores. Secondary end-points were time to resumption of age-appropriate activities, time to resumption of fluid intake, sedation and cooperation. Routine observations and vital signs were also recorded.
Results: Twenty-four patients were studied with a median age of 4.5 years (interquartile range 1.8–9.0 years) and a median weight of 18.4 kg (interquartile range 12.9–33.2 kg). Mean pain difference scores (OM-INF) ranged from −0.500 (95% CI = −1.653 to 0.653) at baseline to −0.625 (05% CI = −1.863 to 0.613) for a retrospective rating of worst pain experienced during the dressing procedure. All measurements were within a pre-defined range of equivalent efficacy. The median time to resumption of fluid intake was 108 min (range 44–175 min) with OM and 140 min (range 60–210 min) with INF. These differences were not statistically significant. Fewer patients experienced mild side-effects with INF compared to OM (n = 5 versus n = 10). No patients experienced depressed respirations or oxygen saturations.
Summary: Intranasal fentanyl was shown to be equivalent to oral morphine in the provision of analgesia for burn wound dressing changes in this cohort of paediatric patients. It was concluded that intranasal fentanyl is a suitable analgesic agent for use in paediatric burns dressing changes either by itself or in combination with oral morphine as a top up titratable agent.
Keyword Intranasal fentanyl
Oral morphine
Pediatric burns
Burns dressings
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 26 Jun 2012, 17:13:23 EST by Elaine Pascoe on behalf of Medicine - Princess Alexandra Hospital