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Intranasal fentanyl

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https://www.readbyqxmd.com/read/29112108/nitrous-oxide-70-for-procedural-analgosedation-in-a-pediatric-emergency-department-with-or-without-intranasal-fentanyl-analgesic-efficacy-and-adverse-events-if-combined-with-intranasal-fentanyl
#1
Michelle Seiler, Markus A Landolt, Georg Staubli
OBJECTIVES: Nitrous oxide 70% (N20 70%) is an excellent medication for procedural analgosedation in a pediatric emergency department. However, its analgesic efficacy remains uncertain for painful procedures; therefore, a combination with intranasal fentanyl (INF), an opioid, was suggested. This study aimed at observing and assessing the analgesic efficacy and rate of adverse events using N20 70% with and without INF. METHODS: Children who received N20 70% in a tertiary children's hospital emergency department from January 1, 2014 to June 30, 2015 were included in this observational study with prospective data collection...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29066928/assessment-and-treatment-of-breakthrough-cancer-pain-from-theory-to-clinical-practice
#2
REVIEW
Renato Vellucci, Rocco Domenico Mediati, Silvia Gasperoni, Massimo Mammucari, Franco Marinangeli, Patrizia Romualdi
Breakthrough cancer pain (BTcP) is a common condition in oncological patients. However, its management is still suboptimal. Improved knowledge of BTcP and its management in clinical practice may have immediate importance for all physicians involved in the supportive care of cancer patients. This review critically discusses the most important concepts for the correct diagnosis of BTcP and presents some intriguing cases of the management of this condition in clinical practice. Overall, the most appropriate therapeutic choice appears to be a rapid-onset opioid (ROO), and in particular, the nasal route of administration is the quickest and most convenient mode of administration for the management of BTcP, especially when the patient needs rapid resolution of pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28967529/intranasal-fentanyl-and-quality-of-pediatric-acute-care
#3
Kathleen M Adelgais, Alison Brent, Joseph Wathen, Suhong Tong, Derrek Massanari, Sara Deakyne, Marion R Sills
BACKGROUND: Changes in the manner in which medications can be delivered can have significant effects on the quality of care in the acute care setting. OBJECTIVE: The objective of this study was to evaluate the change in three Institute of Medicine quality indicators (timeliness, safety, and effectiveness) in the pediatric emergency department (ED) after the introduction of the Mucosal Atomizer Device Nasal™ (MADn) for opioid analgesia. METHODS: This was a retrospective review of patients receiving opioid analgesia for certain conditions over a 5-year period...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#4
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVES: We compared the tolerability and efficacy of intranasal subdissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger noninferiority trial that could investigate the potential opioid-sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared 1 mg/kg intranasal ketamine to 1.5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28735031/taking-the-alternative-route-women-s-experience-of-intranasal-fentanyl-subcutaneous-fentanyl-or-intramuscular-pethidine-for-labour-analgesia
#5
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To compare women's experience of receiving either intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia. DESIGN: A content analysis was undertaken as part of the third phase of a larger randomised controlled trial, using the per-protocol dataset to examine women's experiences of treatment received. Healthy women birthing at term, who received intranasal fentanyl (n=41), subcutaneous fentanyl (n=37) and/or intramuscular pethidine (n=38) for labour analgesia, were contacted at 6 weeks postpartum to complete a phone questionnaire...
October 2017: Midwifery
https://www.readbyqxmd.com/read/28688027/pharmacokinetics-of-fentanyl-and-its-derivatives-in-children-a-comprehensive-review
#6
REVIEW
Victoria C Ziesenitz, Janelle D Vaughns, Gilbert Koch, Gerd Mikus, Johannes N van den Anker
Fentanyl and its derivatives sufentanil, alfentanil, and remifentanil are potent opioids. A comprehensive review of the use of fentanyl and its derivatives in the pediatric population was performed using the National Library of Medicine PubMed. Studies were included if they contained original pharmacokinetic parameters or models using established routes of administration in patients younger than 18 years of age. Of 372 retrieved articles, 44 eligible pharmacokinetic studies contained data of 821 patients younger than 18 years of age, including more than 46 preterm infants, 64 full-term neonates, 115 infants/toddlers, 188 children, and 28 adolescents...
July 7, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28551041/emergency-departments-increasingly-administering-medications-through-the-nose
#7
REVIEW
Deborah L McBride
Administering medications through the nose as an alternative to intramuscular or intravenous injections is increasingly popular in emergency departments and out-of hospital settings because it is simple, fast, and can be used in situations where obtaining intravenous access is difficult or time intensive. This article examines the literature and indications for the out-of-hospital and emergency department administration of five commonly used intranasal medications: midazolam (used to sedate children and treat seizures), fentanyl (for pain relief), naloxone (for opioid overdoses), ketamine (to induce anesthesia) and dexmedetomidine (to sedate and relieve pain in children)...
May 24, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28535115/use-of-naloxone-nasal-spray-4%C3%A2-mg-in-the-community-setting-a-survey-of-use-by-community-organizations
#8
George K Avetian, Phillip Fiuty, Silvana Mazzella, Dave Koppa, Vivian Heye, Pratibha Hebbar
OBJECTIVE: Naloxone hydrochloride, an opioid antagonist, has been approved as a concentrated 4 mg dose intranasal formulation for the emergency treatment of known or suspected opioid overdose. This new formulation is easier to use and contains a higher dose of naloxone compared with earlier, unapproved kits. A survey of first responders and community-based organizations was conducted to understand initial real-world experiences with this new formulation for opioid overdose reversal...
June 7, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28460806/fracture-reduction-in-the-ed-and-intranasal-fentanyl-50mcg-ml-in-children
#9
LETTER
P Hallas, J Cordtz
No abstract text is available yet for this article.
November 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#10
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN: A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised controlled trial. This phase of the study examined breastfeeding intention and experience from the first hour of birth to 6 weeks postpartum. Medical records were audited and women were contacted at 6 weeks postpartum to complete a telephone questionnaire...
April 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28366351/when-to-pick-the-nose-out-of-hospital-and-emergency-department-intranasal-administration-of-medications
#11
REVIEW
Megan A Rech, Brian Barbas, Whitney Chaney, Elizabeth Greenhalgh, Charles Turck
The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain...
August 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#12
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
July 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28243139/an-observational-feasibility-study-to-assess-the-safety-and-effectiveness-of-intranasal-fentanyl-for-radiofrequency-ablations-of-the-lumbar-facet-joints
#13
Michael W Bartoszek, Amy McCoart, Kyung-Soo Jason Hong, Chelsey Haley, Krista Beth Highland, Anthony R Plunkett
PURPOSE: The purpose of the present observational, feasibility study is to assess the preliminary safety and effectiveness of intranasal fentanyl for lumbar facet radiofrequency ablation procedures. PATIENTS AND METHODS: This cohort observational study included 23 adult patients. Systolic and diastolic blood pressures, heart rate, oxygen saturation percent, Pasero Opioid-Induced Sedation Scale score, and the Defense and Veterans Pain Rating Scale pain score were assessed prior to the procedure and intranasal fentanyl (100 μg) administration and every 15 minutes after administration, up to 60 minutes post administration...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28190665/intranasal-fentanyl-and-inhaled-nitrous-oxide-for-fracture-reduction-the-fan-observational-study
#14
MULTICENTER STUDY
J Hoeffe, E Doyon Trottier, B Bailey, D Shellshear, M Lagacé, C Sutter, G Grimard, R Cook, F E Babl
INTRODUCTION: Procedural sedation and analgesia (PSA) are frequently used for fracture reduction in pediatric emergency departments (ED). Combining intranasal (IN) fentanyl with inhalation of nitrous oxide (N2O) allow for short recovery time and obviates painful and time-consuming IV access insertions. METHODS: We performed a bicentric, prospective, observational cohort study. Patients aged 4-18years were included if they received combined PSA with IN fentanyl and N2O for the reduction of mildly/moderately displaced fracture or of dislocation...
May 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28121974/intranasal-analgesia-and-sedation-in-pediatric-emergency-care-a-prospective-observational-study-on-the-implementation-of-an-institutional-protocol-in-a-tertiary-children-s-hospital
#15
Marcus Nemeth, Nils Jacobsen, Carsten Bantel, Melanie Fieler, Robert Sümpelmann, Christoph Eich
OBJECTIVES: Children presenting with acute traumatic pain or in need of therapeutic or diagnostic procedures require rapid and effective analgesia and/or sedation. Intranasal administration (INA) promises to be a reliable, minimally invasive delivery route. However, INA is still underused in Germany. We hence developed a protocol for acute pain therapy (APT) and urgent analgesia and/or sedation (UAS). Our aim was to evaluate the effectiveness and safety of our protocol. METHODS: We performed a prospective observational study in a tertiary children's hospital in Germany...
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27862905/intranasal-fentanyl-for-initial-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease
#16
RANDOMIZED CONTROLLED TRIAL
Daniel M Fein, Jeffrey R Avner, Kathryn Scharbach, Deepa Manwani, Hnin Khine
BACKGROUND: Analgesia administration for children with vaso-occlusive crises is often delayed in the emergency department. Intranasal fentanyl (INF) has been shown to be safe and effective in providing rapid analgesia for other painful conditions. Our objective was to determine if children with a vaso-occlusive crisis (VOC) who received initial treatment with INF compared to placebo achieved a greater decrease in pain score after 20 min. PROCEDURE: This was a randomized, double-blind, placebo-controlled trial...
June 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27625351/intranasal-opioid-administration-in-rhesus-monkeys-pet-imaging-and-antinociception
#17
Phillip A Saccone, Angela M Lindsey, Robert A Koeppe, Kathy A Zelenock, Xia Shao, Phillip Sherman, Carole A Quesada, James H Woods, Peter J H Scott
The goal of this study was to evaluate the effects of intranasally administered opioids in rhesus monkeys using the tail-withdrawal assay, and to correlate these effects with measures of receptor occupancy using positron emission tomography (PET) imaging. Initial experiments characterized the antinociceptive effects of intranasal (IN) fentanyl and buprenorphine relative to intramuscular (IM) injection. Fentanyl (0.010-0.032 mg/kg) and buprenorphine (0.1-1.0 mg/kg) produced dose-dependent increases in tail-withdrawal latency that did not differ between routes of delivery...
November 2016: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27609854/study-protocol-of-a-randomised-controlled-trial-of-intranasal-ketamine-compared-with-intranasal-fentanyl-for-analgesia-in-children-with-suspected-isolated-extremity-fractures-in-the-paediatric-emergency-department
#18
Stacy L Reynolds, Jonathan R Studnek, Kathleen Bryant, Kelly VanderHave, Eric Grossman, Charity G Moore, James Young, Melanie Hogg, Michael S Runyon
INTRODUCTION: Fentanyl is the most widely studied intranasal (IN) analgesic in children. IN subdissociative (INSD) ketamine may offer a safe and efficacious alternative to IN fentanyl and may decrease overall opioid use during the emergency department (ED) stay. This study examines the feasibility of a larger, multicentre clinical trial comparing the safety and efficacy of INSD ketamine to IN fentanyl and the potential role for INSD ketamine in reducing total opioid medication usage. METHODS AND ANALYSIS: This double-blind, randomised controlled, pilot trial will compare INSD ketamine (1 mg/kg) to IN fentanyl (1...
September 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27411064/multicenter-evaluation-of-prehospital-opioid-pain-management-in-injured-children
#19
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Daniel G Ostermayer, Stacy Reynolds, Clare E Guse, David C Brousseau, E Brooke Lerner
BACKGROUND: The National Association of Emergency Medical Services Physicians' (NAEMSP) Position Statement on Prehospital Pain Management and the joint National Highway Traffic Safety Administration (NHTSA) and Emergency Medical Services for Children (EMSC) Evidence-based Guideline for Prehospital Analgesia in Trauma aim to improve the recognition, assessment, and treatment of prehospital pain. The impact of implementation of these guidelines on pain management in children by emergency medical services (EMS) agencies has not been assessed...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27387971/randomized-trial-of-intranasal-fentanyl-versus-intravenous-morphine-for-abscess-incision-and-drainage
#20
Daniel B Fenster, Peter S Dayan, John Babineau, Linda Aponte-Patel, Daniel S Tsze
OBJECTIVES: Abscess incision and drainage (I&D) are painful and distressing procedures in children. Intranasal (IN) fentanyl is an effective analgesic for reducing symptomatic pain associated with fractures and burns but has not been studied for reducing procedural pain during abscess I&D. Our objective was to compare the analgesic efficacy of IN fentanyl with intravenous (IV) morphine for abscess I&D in children. METHODS: We performed a randomized noninferiority trial in children aged 4 to 18 years undergoing abscess I&D in a pediatric emergency department...
July 12, 2016: Pediatric Emergency Care
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