An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.

INTRODUCTION The use of intranasal fentanyl as an alternative type of analgesia has been shown to be effective in paediatric populations and prehospital settings. Studies on the use of intranasal fentanyl in adult patients in emergency settings are limited. METHODS An open-label study was c...

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Main Authors:	Chew, Keng Sheng, Shaharudin, Abdul Hafiz
Format:	Article
Language:	English
Published:	Singapore Medical Journal 2016
Subjects:	R Medicine (General) RZ Other systems of medicine
Online Access:	http://ir.unimas.my/12153/ http://ir.unimas.my/12153/ http://ir.unimas.my/12153/ http://ir.unimas.my/12153/1/An%20open-label%20randomised%20controlled%20trial%20on%20the%20efficacy%20of%20adding%20intranasal%20fentanyl%20%28abstract%29.pdf

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spelling	unimas-121532017-02-22T07:23:25Z http://ir.unimas.my/12153/ An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries. Chew, Keng Sheng Shaharudin, Abdul Hafiz R Medicine (General) RZ Other systems of medicine INTRODUCTION The use of intranasal fentanyl as an alternative type of analgesia has been shown to be effective in paediatric populations and prehospital settings. Studies on the use of intranasal fentanyl in adult patients in emergency settings are limited. METHODS An open-label study was conducted to evaluate the effectiveness of the addition of 1.5 mcg/kg intranasal fentanyl to 2 mg/kg intravenous tramadol (fentanyl + tramadol arm, n = 10) as compared to the administration of 2 mg/kg intravenous tramadol alone (tramadol-only arm, n = 10) in adult patients with moderate to severe pain due to acute musculoskeletal injuries. RESULTS When analysed using the independent t-test, the difference the between the mean visual analog scale scores pre-intervention and ten-minute post-intervention was 29.8 ± 8.4 mm in the fentanyl + tramadol arm and 19.6 ± 9.7 mm in the tramadol-only arm (t[18] = 2.515, p = 0.022, 95% confidence interval 1.68-18.72 mm). A statistically significant, albeit transient, reduction in the ten-minute post-intervention mean arterial pressure was noted in the fentanyl + tramadol arm as compared to the tramadol-only arm (13.35 mmHg vs. 7.65 mmHg; using Mann-Whitney U test with U-value = 21.5, p = 0.029, r = 0.48). There was a higher incidence of transient dizziness ten minutes after intervention among the patients in the fentanyl + tramadol arm. CONCLUSION Although effective, intranasal fentanyl may not be appropriate for routine use in adult patients as it may result in a significant reduction in blood pressure. Singapore Medical Journal 2016-05-19 Article PeerReviewed text en http://ir.unimas.my/12153/1/An%20open-label%20randomised%20controlled%20trial%20on%20the%20efficacy%20of%20adding%20intranasal%20fentanyl%20%28abstract%29.pdf Chew, Keng Sheng and Shaharudin, Abdul Hafiz (2016) An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries. Singapore medical journal, 2016. ISSN 0037-5675 https://sma.org.sg/publications/index.aspx?ID=220 10.11622/smedj.2016096
repository_type	Digital Repository
institution_category	Local University
institution	Universiti Malaysia Sarawak
building	UNIMAS Institutional Repository
collection	Online Access
language	English
topic	R Medicine (General) RZ Other systems of medicine
spellingShingle	R Medicine (General) RZ Other systems of medicine Chew, Keng Sheng Shaharudin, Abdul Hafiz An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
description	INTRODUCTION The use of intranasal fentanyl as an alternative type of analgesia has been shown to be effective in paediatric populations and prehospital settings. Studies on the use of intranasal fentanyl in adult patients in emergency settings are limited. METHODS An open-label study was conducted to evaluate the effectiveness of the addition of 1.5 mcg/kg intranasal fentanyl to 2 mg/kg intravenous tramadol (fentanyl + tramadol arm, n = 10) as compared to the administration of 2 mg/kg intravenous tramadol alone (tramadol-only arm, n = 10) in adult patients with moderate to severe pain due to acute musculoskeletal injuries. RESULTS When analysed using the independent t-test, the difference the between the mean visual analog scale scores pre-intervention and ten-minute post-intervention was 29.8 ± 8.4 mm in the fentanyl + tramadol arm and 19.6 ± 9.7 mm in the tramadol-only arm (t[18] = 2.515, p = 0.022, 95% confidence interval 1.68-18.72 mm). A statistically significant, albeit transient, reduction in the ten-minute post-intervention mean arterial pressure was noted in the fentanyl + tramadol arm as compared to the tramadol-only arm (13.35 mmHg vs. 7.65 mmHg; using Mann-Whitney U test with U-value = 21.5, p = 0.029, r = 0.48). There was a higher incidence of transient dizziness ten minutes after intervention among the patients in the fentanyl + tramadol arm. CONCLUSION Although effective, intranasal fentanyl may not be appropriate for routine use in adult patients as it may result in a significant reduction in blood pressure.
format	Article
author	Chew, Keng Sheng Shaharudin, Abdul Hafiz
author_facet	Chew, Keng Sheng Shaharudin, Abdul Hafiz
author_sort	Chew, Keng Sheng
title	An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
title_short	An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
title_full	An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
title_fullStr	An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
title_full_unstemmed	An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
title_sort	open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.
publisher	Singapore Medical Journal
publishDate	2016
url	http://ir.unimas.my/12153/ http://ir.unimas.my/12153/ http://ir.unimas.my/12153/ http://ir.unimas.my/12153/1/An%20open-label%20randomised%20controlled%20trial%20on%20the%20efficacy%20of%20adding%20intranasal%20fentanyl%20%28abstract%29.pdf
first_indexed	2018-09-06T15:58:16Z
last_indexed	2018-09-06T15:58:16Z
_version_	1610874352075538432

An open-label randomised controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries.

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