A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia - 21/08/11

Doi : 10.1016/j.ajem.2004.03.010

Michel Galinski, MD ^a,⁎ , François Dolveck, MD ^b, Stephen W. Borron, MD, MS ^c, Loic Tual, MD, MS ^d, Vincent Van Laer, MD ^e, Jean-Yves Lardeur, MD ^f, Frédéric Lapostolle, MD ^a, Frédéric Adnet, MD, PhD ^a
^a Samu 93-Department of Anesthesiology and Intensive Care, Upres EA 3409, Avicenne Hospital, 93009 Bobigny Cedex, France
^b Samu 92-Department of Anesthesiology and Intensive Care, R Poincaré Hospital, 92380 Garches, France
^c Departments of Emergency Medicine and Medicine, George Washington University Washington, DC, USA
^d Smur 95, Department of Emergency, 95500 Gonesse Hospital, France
^e Samu 59, Department of Emergency, CHRU, 59000 Lille, France
^f Samu 86, Department of Anesthesiology and Intensive Care, 86000 Poitiers Hospital, France

^*Corresponding author. Tel.: +33 1 48 96 44 55; fax: +33 1 48 96 44 45.

Abstract

Study 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 μg/kg then of 30 μg 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.

Conclusion

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.

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Plan

Introduction

Materials and methods

Results

Discussion

☆	Financial support was given by the School of Medicine, Paris 13 University.

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Vol 23 - N° 2

P. 114-119 - mars 2005 Retour au numéro

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A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia - 21/08/11

Abstract

Study Objective

Methods

Results

Conclusion

Plan

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