A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting

Rickard, Claire M; O’Meara, Peter; McGrail, Matthew Richard; Garner, David M.; Mclean, A. J.; Lievre, P. Le

doi:10.1016/j.ajem.2007.02.027

Cited by 140 publications

(108 citation statements)

References 24 publications

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“…Morphine was similar to buprenorphine (Weiss & Ritz, 1988 Level II) and pethidine (Nielsen et al, 1984 Level II) in terms of analgesia and adverse effects. IN fentanyl and IV morphine were equally effective in reducing acute cardiac chest pain during prehospital transfer (Rickard et al, 2007 Level II).…”

Section: Chaptermentioning

confidence: 99%

“…and IV morphine were equally effective in reducing acute cardiac chest pain during prehospital transfer (Rickard et al, 2007 Level II). In a study of patients with post-traumatic thoracic pain, there was no difference in analgesia between nebulised morphine and morphine PCA (Fulda et al, 2005 Level II).…”

Section: For Details) In Fentanylmentioning

confidence: 99%

“…When fentanyl was used in the prehospital setting, there was no difference in effectiveness between IN fentanyl (180 mcg +/-2 doses of 60 mcg at > or =5 minute intervals) and IV morphine (2.5 to 5 mg +/-2 doses of 2.5 to 5 mg at > or =5-minute intervals) (Rickard et al, 2007 Level II).…”

Section: Chaptermentioning

confidence: 99%

“…As in other settings, pain intensity is best assessed using patient self-report measures such as VASs (Galinski et al, 2005;Kober et al, 2002), VNRSs (McLean et al, 2004;Woollard et al, 2004;Rickard et al, 2007;Bounes et al, 2008), VDSs (McLean et al, 2004;Vergnion et al, 2001), faces pain scales (Rogovik & Goldman, 2007) (see Section 2). A ruler incorporating both visual analogue and faces pain scales (Lord & Parsell, 2003 Level IV) has also been used to measure pain in patients prior to arrival at hospital.…”

Section: Assessment Of Pain In the Prehospital Environmentmentioning

confidence: 99%

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Safety of opioid patch initiation in Australian residential aged care

Gadzhanova

Roughead

Pont

2015

Medical Journal of Australia

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Objective: To explore opioid use by aged care facility residents before and after initiation of transdermal opioid patches. Design: A cross‐sectional cohort study, analysing pharmacy data on individual patient supply between 1 July 2008 and 30 September 2013. Setting: Sixty residential aged care facilities in New South Wales. Participants: Residents receiving an initial opioid patch during the study period. Main outcome measure: The proportion of residents who were opioid‐naive in the 4 weeks prior to patch initiation was determined. In addition, the patch strength at initiation and the daily dose of transdermal patches and of additional opioids 1 month after initiation were determined. Results: An opioid patch was initiated in 596 of 5297 residents (11.3%: 2.6% fentanyl, 8.7% buprenorphine) in the 60 residential aged care facilities. The mean age at initiation was 87 years, and 74% of the recipients were women. The proportion of recipients who were opioid‐naive before patch initiation was 34% for fentanyl and 49% for buprenorphine. Most were initiated at the lowest available patch strength, and the dose was up‐titrated after initiation. Around 15% of fentanyl users and 10% of buprenorphine users needed additional regular opioids after patch initiation. Conclusions: The results suggest some inappropriate initiation of opioid patches in Australian residential aged care facilities. Contrary to best practice, a third of residents initiated on fentanyl patches were opioid‐naive in the 4 weeks before initiation.

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Section: Chaptermentioning

confidence: 99%

Section: For Details) In Fentanylmentioning

confidence: 99%

Section: Chaptermentioning

confidence: 99%

Section: Assessment Of Pain In the Prehospital Environmentmentioning

confidence: 99%

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Safety of opioid patch initiation in Australian residential aged care

Gadzhanova

Roughead

Pont

2015

Medical Journal of Australia

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“…It has been suggested that within 15 minutes of administration, only 50% of the patients experience pain control. [4,8,9] Therefore, despite noticeable strides, pain control in the ED is still an unresolved issue. [3,[1][2][3][4][5][6][7][8][9][10][11][12] Consequently, researchers have proposed other drug regimens to reduce MS consumption in the ED.…”

mentioning

confidence: 99%