A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting - 09/08/11
, Peter O'Meara, PhD b, Matthew McGrail, GDip(IT) c, David Garner, MICA d, Alan McLean, BHlthSc e, Peter Le Lievre, BBus fAbstract |
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.
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Vol 25 - N° 8
P. 911-917 - octobre 2007 Retour au numéro
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