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Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review
INTRODUCTION: Pre-hospital analgesic treatment of injured children is suboptimal, with very few children in pain receiving analgesia. Studies have identified a number of barriers to pre-hospital pain management in children which include the route of analgesia administration. The aim of this review i...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The College of Paramedics
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783922/ https://www.ncbi.nlm.nih.gov/pubmed/33447148 http://dx.doi.org/10.29045/14784726.2019.12.4.3.24 |
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author | Whitley, Gregory Adam Pilbery, Richard |
author_facet | Whitley, Gregory Adam Pilbery, Richard |
author_sort | Whitley, Gregory Adam |
collection | PubMed |
description | INTRODUCTION: Pre-hospital analgesic treatment of injured children is suboptimal, with very few children in pain receiving analgesia. Studies have identified a number of barriers to pre-hospital pain management in children which include the route of analgesia administration. The aim of this review is to critically evaluate the pre-hospital literature, exploring the safety and efficacy of intranasal (IN) analgesics for children suffering pain. METHODS: We performed a rapid evidence review, searching from inception to 17 December 2018, CINAHL, MEDLINE and Google Scholar. We included studies of children < 18 years suffering pain who were administered any IN analgesic in the pre-hospital setting. Our outcomes were effective pain management, defined as a pain score reduction of ≥ 2 out of 10, safety and rates of analgesia administration. Screening and risk of bias assessments were performed in duplicate. We performed a narrative synthesis. RESULTS: From 310 articles screened, 23 received a full-text review resulting in 10 articles included. No interventional studies were found. Most papers reported on the use of intranasal fentanyl (INF) (n = 8) with one reporting IN ketamine and the other IN S-ketamine. Narrative synthesis showed that INF appeared safe and effective at reducing pain; however, its ability to increase analgesia administration rates was unclear. The effectiveness, safety and ability of IN ketamine and S-ketamine to increase analgesia administration rates were unclear. There was no evidence for IN diamorphine for children in this setting. CONCLUSION: Interventional studies are needed to determine with a higher confidence the effectiveness and safety of IN analgesics (fentanyl, ketamine, S-ketamine, diamorphine) for children in the pre-hospital setting. |
format | Online Article Text |
id | pubmed-7783922 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The College of Paramedics |
record_format | MEDLINE/PubMed |
spelling | pubmed-77839222021-01-13 Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review Whitley, Gregory Adam Pilbery, Richard Br Paramed J Literature Review INTRODUCTION: Pre-hospital analgesic treatment of injured children is suboptimal, with very few children in pain receiving analgesia. Studies have identified a number of barriers to pre-hospital pain management in children which include the route of analgesia administration. The aim of this review is to critically evaluate the pre-hospital literature, exploring the safety and efficacy of intranasal (IN) analgesics for children suffering pain. METHODS: We performed a rapid evidence review, searching from inception to 17 December 2018, CINAHL, MEDLINE and Google Scholar. We included studies of children < 18 years suffering pain who were administered any IN analgesic in the pre-hospital setting. Our outcomes were effective pain management, defined as a pain score reduction of ≥ 2 out of 10, safety and rates of analgesia administration. Screening and risk of bias assessments were performed in duplicate. We performed a narrative synthesis. RESULTS: From 310 articles screened, 23 received a full-text review resulting in 10 articles included. No interventional studies were found. Most papers reported on the use of intranasal fentanyl (INF) (n = 8) with one reporting IN ketamine and the other IN S-ketamine. Narrative synthesis showed that INF appeared safe and effective at reducing pain; however, its ability to increase analgesia administration rates was unclear. The effectiveness, safety and ability of IN ketamine and S-ketamine to increase analgesia administration rates were unclear. There was no evidence for IN diamorphine for children in this setting. CONCLUSION: Interventional studies are needed to determine with a higher confidence the effectiveness and safety of IN analgesics (fentanyl, ketamine, S-ketamine, diamorphine) for children in the pre-hospital setting. The College of Paramedics 2019-12-01 2019-12-01 /pmc/articles/PMC7783922/ /pubmed/33447148 http://dx.doi.org/10.29045/14784726.2019.12.4.3.24 Text en © 2019 The Author(s) https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Literature Review Whitley, Gregory Adam Pilbery, Richard Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
title | Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
title_full | Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
title_fullStr | Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
title_full_unstemmed | Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
title_short | Pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
title_sort | pre-hospital intranasal analgesia for children suffering pain: a rapid evidence review |
topic | Literature Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783922/ https://www.ncbi.nlm.nih.gov/pubmed/33447148 http://dx.doi.org/10.29045/14784726.2019.12.4.3.24 |
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