A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia.
OBJECTIVE
The aim of this study was to compare, by a randomized double-blind method, morphine (M) and fentanyl (F) in a prehospital setting.


METHODS
Consecutive patients with severe, acute pain defined as a visual analog scale score (VASS) of 60/100 or higher were included. The M group received an initial intravenous M injection of 0.1 mg/kg then of 3 mg every 5 minutes. The F group received an initial intravenous F injection of 1 microg/kg then of 30 microg every 5 minutes. The goal of analgesia was a VASS of 30/100 or lower. The end point was the VASS measured 30 minutes after initial administration (VAS [T30]).


RESULTS
There were 26 patients included in the M group and 28 in the F group. Initial VASS(T0) and VASS(T30), mean (95% CI), were 83 (78-88) and 40 (28-52) in the M group and 77 (72-82) and 35 (27-43) in the F group (P=NS). Sixty-two percent of patients in the M group described analgesia as excellent or good vs 76% of those in the F group who did (P=NS). There were no differences in the incidence of side effects in the 2 groups.


CONCLUSIONS
This study demonstrates that M and F were comparable in treating severe, acute pain in a prehospital setting during the first 30 minutes in spontaneous breathing patients.
Galinski
Michel
M
Samu 93-Department of Anesthesiology and Intensive Care, Avicenne Hospital, Bobigny, France. michel.galinski@avc.ap-hop-paris.fr
Dolveck
François
F
Borron
Stephen W
SW
Tual
Loic
L
Van Laer
Vincent
V
Lardeur
Jean-Yves
JY
Lapostolle
Frédéric
F
Adnet
Frédéric
F
D000208:Acute Disease; D000328:Adult; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004311:Double-Blind Method; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl