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Multicenter Study
. 2024 Sep 4;8(1):e002719.
doi: 10.1136/bmjpo-2024-002719.

Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department

Giorgio Cozzi  1 , Sara Chiappa  2 , Giovanna La Fauci  3 , Matteo Calvi  4 , Emanuele Castagno  5 , Eleonora Tappi  6 , Giovanna Villa  7 , Paola Tommasi  8 , Gregorio Paolo Milani  9   10 , Marta Cellai Rustici  11 , Maria Luisa Casciana  12 , Nicola Tovaglieri  13 , Stefano Masi  11 , Cesare Vezzoli  2 , Sofia Zeuditù Tilatti  14 , Manuela Giangreco  15 , Egidio Barbi  1   14 , Franca Benini  16
Affiliations
Multicenter Study

Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department

Giorgio Cozzi et al. BMJ Paediatr Open. .

Abstract

Background: Despite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes.

Methods: A multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group. It included a survey and a retrospective data collection in which the medical records of all patients who received analgesia from 1 April 2022 to 31 May 2022 were collected.

Results: 48 centres (91%) answered the survey. The intranasal and sublingual routes were used in 25 centres (52%). 13 centres (27%) used both routes, 9 centres (19%) used only the sublingual and 3 centres (6%) used only the intranasal route.12 centres (48%) participated in the retrospective study. Data about 3409 patients, median age 9 years (IQR 5-12), were collected. Among them, 337 patients (9.6%) received sublingual analgesia, and 87 patients (2.5%) received intranasal analgesia. The intranasal route was employed for injuries in 79 (90.8%) cases, and fentanyl was the drug delivered in 85 (97.7%) cases. The sublingual route was used mainly for injuries (57.3%), but also for abdominal pain (15.4%), musculoskeletal pain (14.5%) and headache (10.7%). Paracetamol, ketorolac and tramadol were administered through this route.

Conclusions: The use of the intranasal and sublingual routes for analgesia in the paediatric ED is still limited.

Keywords: Analgesia.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Distribution of pain’s causes by route of administration. Percentage is shown in the figure.
See this image and copyright information in PMC

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