By: 9 March 2015
Emergency doctors can treat paediatric pain without a needle

Children in emergency departments can safely be treated for paediatric pain from limb injuries using intranasal ketamine, a drug more typically used for sedation, according to the results of the first randomised, controlled trial comparing intranasal analgesics in children in the emergency department.

The Australian study, published in Annals of Emergency Medicine compared intranasal ketamine with fentanyl for the relief of moderate to paediatric pain in children with limb injuries.
“This is great news for emergency physicians and their young patients, especially those who may not tolerate other intranasal pain medications such as fentanyl,” said lead study author Andis Graudins of Monash University in Australia. “For children in pain and distress, the option of treating their pain without a needle is a huge benefit as well. The intranasal option using fentanyl is accepted already for children, but the safe use of ketamine is new.”
Source: American College of Emergency Physicians News

Graudins, A., Meek, R., Egerton-Warburton, D., et al. (2014) The PICHFORK (Pain in Children Fentanyl OR Ketamine) Trial: A randomized controlled trial comparing intranasal ketamine and fentanyl for the relief of moderate to severe pain in children with limb injuries. Ann. Emerg. Med. DOI: