Comparison of efficacy nebulized fentanyl with intravenous ketorolac for renal colic in patients over 12 years old

Rezaei, Bareza; Salimi, Rasoul; Kalantari, Alireza; Astaraki, Peyman

doi:10.1016/j.ajem.2020.04.053

Cited by 9 publications

(8 citation statements)

References 24 publications

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“…The use of nebulized fentanyl for acute pain secondary to renal colic has also been evaluated (Imamoglu et al, 2017; Rezaei et al, 2021). One study compared IV fentanyl (1.5 mcg/kg) with nebulized fentanyl (3 mcg/kg) in 115 patients randomized between these two groups.…”

Section: Fentanylmentioning

confidence: 99%

“…The rapid onset facilitates the completion of a diagnostic workup with a lower incidence of hemodynamic side effects while allowing for rapid clinical reevaluation (Chudnofsky, Wright, Dronen, Borron, & Wright, 1989;Peng & Sandler, 1999). Hence, nebulized fentanyl has been one of the most commonly evaluated opioids for the treatment of acute pain in the ED including for the treatment of abdominal pain, acute limb pain, and renal colic (Bartfield, Flint, McErlean, & Broderick, 2003;Deaton, Auten, & Darracq, 2015;Farahmand et al, 2014;Furyk, Grabowski, & Black, 2009;Imamoglu et al, 2017;Maleki Verki, Mozafari, Tirandaz, Motamed, & Khazaeli, 2019;Rezaei, Salimi, Kalantari, & Astaraki, 2021;Thompson & Thompson, 2016). The doses of fentanyl studied via nebulization range from the most commonly used doses via the intravenous (IV) route (1-2 mcg/kg) given via nebulization.…”

Section: Fentanylmentioning

confidence: 99%

“…The pain treatment was described as adequate by the treating physician and there was no statistical difference between the two groups and no adverse events were reported (Miner et al, 2007). The use of nebulized fentanyl for acute pain secondary to renal colic has also been evaluated (Imamoglu et al, 2017;Rezaei et al, 2021). One study compared IV fentanyl (1.5 mcg/kg) with nebulized fentanyl (3 mcg/kg) in 115 patients randomized between these two groups.…”

Section: Side Effectsmentioning

confidence: 99%

“…Patients receiving IV fentanyl had lower rescue analgesia requirements (37.1% vs. 54.7%), but adverse effects were more frequent in the IV fentanyl group (22.1% vs. 9.4%), although neither difference was statistically significant (Imamoglu et al, 2017). Another study of pediatric and adult patients with renal colic ( n = 186) compared 0.9 mg/kg IV ketorolac with 3 mcg/kg nebulized fentanyl (Rezaei et al, 2021). They evaluated pain scores and found that although fentanyl was safe, IV ketorolac was statistically significantly better at achieving complete pain relief at 2 hr after the intervention than fentanyl (Rezaei et al, 2021).…”

Section: Fentanylmentioning

confidence: 99%

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Put It in the Air? Nebulized Opioids in the Emergency Department

Bailey,

Weant

2023

Advanced Emergency Nursing Journal

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The emergency department (ED) is a frequent utilizer of alternative routes of medication administration (e.g., intranasal) for a variety of indications. Over the last several years, investigations into the use of medications via the nebulization route have greatly increased, with varying degrees of efficacy identified. This route has multiple theoretical advantages. Medications affecting bronchopulmonary function or secretions can be administered directly to the site of action, possibly utilizing a lower dose and hence minimizing side effects. It is also possible to have a faster onset of action compared with other routes, given the enhanced surface area for absorption. One group of medications that has been explored via this route of administration, and is frequently administered in EDs across the nation, is opioids, most notably fentanyl, hydromorphone, and morphine. However multiple questions exist regarding the implementation of these therapies via this route, including efficacy, dosing, and the functional aspects of medication administration that are more complex than that of more traditional routes. The intent of this review is to explore the supporting literature behind the use of nebulized opioids, most specifically fentanyl, hydromorphone, and morphine, in the ED for the treatment of acute pain presentations and provide the most up-to-date guidance for practitioners.

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Section: Fentanylmentioning

confidence: 99%

Section: Fentanylmentioning

confidence: 99%

Section: Side Effectsmentioning

confidence: 99%

Section: Fentanylmentioning

confidence: 99%

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Put It in the Air? Nebulized Opioids in the Emergency Department

Bailey,

Weant

2023

Advanced Emergency Nursing Journal

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“…21,22 Recent studies have shown that electrolyte imbalance is often associated with disorders such as severe cardiovascular events like myocardial infarctions, acute or chronic renal failures, and diabetes mellitus. 23,24 Based on our knowledge, studies are generally focused on imbalances of specific electrolytes, and most of the studies recruited patients of a specific disease or risk group. 25 Recently, agerelated differences in electrolyte imbalance have been reported in the emergency department.…”

mentioning

confidence: 99%

A cross‐sectional study on the prevalence of electrolyte abnormalities in multiple trauma patients in Hamedan, Iran

Rezaei

Ramazani

Amiri

et al. 2021

Health Science Reports

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Introduction Evaluation of electrolyte status and homeostasis is one of the most important components of evaluation and treatment of critically ill patients, especially those with multiple trauma. Electrolyte imbalance can be associated with a bad prognosis and the need of specialized consultancy. Aim The aim of this study was to evaluate and determine the electrolyte status of patients with multiple trauma and evaluate the relationship of electrolyte disorders with patient outcome. Methods In this cross‐sectional study, 370 patients who were referred to the emergency department of Besat Hospital in Hamadan, Iran with multiple trauma were studied. Demographic parameters clinical characteristics such as blood pressure, heart rate, respiratory rate, consciousness score and body temperature, paraclinical characteristics including radiographic status, ultrasound, and electrocardiography and serum levels of sodium, potassium, creatinine, hemoglobin, hematocrit, and BUN and urine analysis was performed. Data regarding the discharge from emergency department or referral to other units were also complete in a questionnaire for each patient. Statistical analyses were performed using SPSSv24. Results Three hundred seventy patients with multiple trauma were studied where 73% of patients were men and 27% were women. One hundred ninety‐six patients were discharged from the emergency department, and 174 patients were referred to other units of the hospital. The most common electrolyte abnormalities were hypotension (62.7%), hypernatremia (9.5%), hypokalemia (6.8%), and hypercreatinine (4.6%). The results of independent t ‐test showed that heart rate and potassium level were significantly higher in patients referred to other units than in patients discharged from the emergency department and respiratory rate and hematocrit were significantly lower in patients referred to other units. Conclusion Hypotension, hypernatremia, hypokalemia, hypercreatinine, and abnormal urine analysis were more frequent in patients referred to other units than in patients discharged from the emergency department. These variables can be considered in predicting patient status for referral to other units and delayed hospital discharge.

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