Intranasal Fentanyl Versus Oral Morphine Sulfate in the Treatment of Pain in Pediatric Trauma

Non-inferiority of Intranasal Fentanyl Versus Oral Morphine Sulfate in the Treatment of Pain in Pediatric Trauma : a Controled Randomized , Single Blind Study

Acute tramatic pain is one of main reasons for consultation in pediatric emergency departments.

To manage pain quickly and effectively must be a primary outcome of the emergency department. However, pediatric emergency department are sometimes criticized for inadequate and delayed initiation analgesia . Indeed, several studies have shown the inadequacy between the intensity of the pain evaluated by the care team and the therapeutic management of it.

The ideal analgesic must have a rapid onset of action, have a powerful analgesic effect, have few side effects and can be administered quickly and painlessly. That's why, the main outcome of this study is to assess the non inferiority of a treatment by intranasal Fentanyl vs morphine sulfate (oral use) in children with traumatic pain on arrival to pediatric emergency department.

Inclusion Criteria:

• Patient aged between 4 years old and 15,3 years old
• Acute pain in traumatic context with a suspicion of fracture for patient <7years old : feeling Pain >6/10 defined with a face analogue scale and a visual analogic scale (the difference between the scales is not <10 points)
• For patients >7 years old : feeling pain >6 points and defined thanks to a visual analogic scale
• Informed consent form signed by parents
• Beneficiary of an european health protection

Exclusion Criteria:

• Antalgic ( II or III) within 4 hours before the inclusion
• Allergic or non-indication of fentanyl
• Allergic or contraindication of morphine sulfate
• Pre existing peripheral intravenous catheter
• Traumatic brain injury
• Nasal traumatic