title: Does intranasal fentanyl provide efficient analgesia for renal colic in adults?
abstract: BACKGROUND
  Intranasal fentanyl provides rapid and powerful analgesia which is particularly interesting in patients without intravenous access. We propose to use it for analgesia in adults presenting renal colics.
  
  
  METHODS
  A prospective study was conducted from the 2nd January to February 2013 in our emergency department. Patients aged up to 18 years old who presented with renal colic were included in this audit. Patients were excluded if they had loss of consciousness, cognitive impairment, acute or chronic nasal problems. A formal written consent was obtained from patients. The research team was alerted by medical and nursing staff. A member of the research team would check with medical or nursing staff whether administration of Intra nasal (IN) fentanyl was required. It was administered at a pre-calculated dose of 1.5 mg/kg and 50 mg/ml concentration was used. Data was prospectively collected by one of the researchers at various intervals during the patient's presentation and recorded on a pre-formatted data sheet. Pain scores were collected at 5, 15, 30, 45 and 60 minutes following IN fentanyl using a visual analogue scale pain. Observations routinely collected for patients receiving IV opiates and any adverse events were also recorded.
  
  
  RESULTS
  23 eligible patients were enrolled; median age was 51,3 years. 47,8% were women and the mean weight was 73 kg. Median dose of IN fentanyl was 106 μg. Two patients have required morphinic analgesia despite having received adapted dose of IN fentanyl. The initial pain scores before IN fentanyl were high with a median of 82,2 mm (59-100). Five minutes after IN fentanyl administration the median pain score dropped to 48 mm(36-63) and achieved the lowest score of 8mm(0-22) at 30 min. Pain scores were significantly lower at 5 min (P < 0.001) and at all subsequent time points (P < 0.001). No side effects were recorded.
  
  
  CONCLUSIONS
  Intranasal fentanyl seems to be efficient for analgesia in adult patients with renal colic.
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Ahmed
authors: A
authors: Belkouch
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Saad
authors: S
authors: Zidouh
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Mostafa
authors: M
authors: Rafai
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Naoufal
authors: N
authors: Chouaib
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Rachid
authors: R
authors: Sirbou
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Anass
authors: A
authors: Elbouti
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Hicham
authors: H
authors: Bakkali
authors: Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco.
authors: Lahcen
authors: L
authors: Belyamani
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004636:Emergency Service, Hospital; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D056844:Renal Colic / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: Emergency department; intranasal fentanyl; renal colic