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Intranasal sufentanil provides adequate analgesia for emergency department patients with extremity injuries

Robert Stephen, MD, Erin Lingenfelter, PharmD, Camille Broadwater-Hollifield, MPH, Troy Madsen, MD


Background: In emergency medicine, the ability to provide rapid, adequate pain control without high resource utilization is ideal. In this study, the efficacy of intranasal sufentanil in emergency department (ED) patients with acute distal extremity injury was evaluated.

Methods: A nonrandomized, open-label dose trial to determine safety and efficacy of intranasal sufentanil in patients with a distal extremity injury who presented to the ED with moderate to severe pain was conducted. Vital signs, pain scores, Ramsay sedation score, and any side effects during a 30-minute observation period after medication administration were recorded. Patients, nurses, and physicians completed satisfaction surveys.

Results: Fifteen ED patients with acute extremity injuries agreed to participate in the study and received a dose of 0.5 µg/kg of sufentanil intranasally. The average pain score decreased 4.3 points (from 7.8 to 3.5). Eight patients reported a final pain score of 3. The most common side effect was mild dysphoria. Patients, physicians, and nurses reported high average satisfaction scores.

Conclusion: Intranasal sufentanil resulted in a significant clinical reduction in patients’ reported pain without serious side effects. This medication and administration route demonstrated promise for potential use in the ED.


intranasal, opiate, pain

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