Effectiveness of Intranasal Analgesia in the Emergency Department

Author:

Zanza Christian12,Saglietti Francesco3ORCID,Giamello Jacopo Davide4ORCID,Savioli Gabriele5ORCID,Biancone Davide Maria6,Balzanelli Mario Giosuè1,Giordano Benedetta7,Trompeo Anna Chiara8,Longhitano Yaroslava910ORCID

Affiliation:

1. Italian Society of Prehospital Emergency Medicine-SIS 118-Taranto, 74121 Taranto, Italy

2. Post Graduate School of Geriatric Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy

3. Department of Anesthesia and Critical Care, Santa Croce and Carle Hospital, 12100 Cuneo, Italy

4. Emergency Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy

5. Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy

6. Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy

7. Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy

8. Department of Anesthesia and Critical Care, AOU Città della Scienza e della Salute, 10126 Torino, Italy

9. Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15260, USA

10. Department of Emergency Medicine, Humanitas University, 20089 Milan, Italy

Abstract

In the Emergency Department (ED), pain is one of the symptoms that are most frequently reported, making it one of the most significant issues for the emergency physician, but it is frequently under-treated. Intravenous (IV), oral (PO), and intramuscular (IM) delivery are the standard methods for administering acute pain relief. Firstly, we compared the safety and efficacy of IN analgesia to other conventional routes of analgesia to assess if IN analgesia may be an alternative for the management of acute pain in ED. Secondly, we analyzed the incidence and severity of adverse events (AEs) and rescue analgesia required. We performed a narrative review-based keywords in Pubmed/Medline, Scopus, EMBASE, the Cochrane Library, and Controlled Trials Register, finding only twenty randomized Clinical trials eligible in the timeline 1992–2022. A total of 2098 patients were analyzed and compared to intravenous analgesia, showing no statistical difference in adverse effects. In addition, intranasal analgesia also has a rapid onset and quick absorption. Fentanyl and ketamine are two intranasal drugs that appear promising and may be taken simply and safely while providing effective pain relief. Intravenous is simple to administer, non-invasive, rapid onset, and quick absorption; it might be a viable choice in a variety of situations to reduce patient suffering or delays in pain management.

Publisher

MDPI AG

Subject

General Medicine

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