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Review
. 2023 Mar 30;12(7):2609.
doi: 10.3390/jcm12072609.

Intranasal Fentanyl for Acute Pain Management in Children, Adults and Elderly Patients in the Prehospital Emergency Service and in the Emergency Department: A Systematic Review

Sossio Serra  1 , Michele Domenico Spampinato  2 , Alessandro Riccardi  3 , Mario Guarino  4 , Rita Pavasini  5 , Andrea Fabbri  6 , Fabio De Iaco  7
Affiliations
Review

Intranasal Fentanyl for Acute Pain Management in Children, Adults and Elderly Patients in the Prehospital Emergency Service and in the Emergency Department: A Systematic Review

Sossio Serra et al. J Clin Med. .

Abstract

This systematic review examined the efficacy and safety of intranasal fentanyl (INF) for acute pain treatment in children, adults, and the elderly in prehospital emergency services (PHES) and emergency departments (ED). ClinicalTrials.gov, LILACS, PubMed, SCOPUS, EMBASE, Google Scholar and Cochrane databases were consulted until 31 December 2022. A total of 23 studies were included: 18 in children (1 PHES, 17 ED), 5 in adults (1 PHES, 4 ED) and 1 in older people (1 PHES subgroup analysis). In children, INF was effective in both settings and as effective as the comparator drugs, with no differences in adverse events (AEs); one randomised controlled trial (RCT) showed that INF was more effective than the comparator drugs. In adults, one study demonstrated the efficacy of INF in the PHES setting, one study demonstrated the efficacy of INF in the ED setting, two RCTs showed INF to be less effective than the comparator drugs and one RCT showed INF to be as effective as the comparator, with no difference in AEs reported. In older people, one study showed effective pain relief and no AEs. In summary, INF appears to be effective and safe in children and adults in PHES and ED. More high-quality studies are needed, especially in PHES and older people.

Keywords: emergency department; fentanyl; intranasal administration; pain; prehospital emergency service.

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Conflict of interest statement

The authors declare no conflict of interest.

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Figure 1
PRISMA 2020 flow diagram for identification, screening and study inclusion.
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