The purpose of the study is to compare the effectiveness of a combination of intranasal fentanyl and intranasal midazolam to intranasal midazolam alone for analgesia and anxiolysis in patients presenting for facial laceration repair in the pediatric emergency department.

This study will be a single blind (blinded observer) randomized control trial to evaluate the efficacy of the combination of intranasal fentanyl and intranasal midazolam compared to intranasal midazolam alone for analgesia and anxiolysis during pediatric facial laceration repair.

Inclusion Criteria:

• Facial laceration requiring repair with sutures
• English or Spanish-speaking parent/guardian

Exclusion Criteria:

• Lacerations requiring IV sedation or subspecialist involvement
• Patient has other injuries requiring medical attention
• Patient has vital sign instability, per physician discretion
• Patient has autism spectrum disorder
• Patient has allergies to either medication

A non-blinded researcher (physician) will determine the group to which the patient is assigned and order the medication(s) according to the assigned group. A separate blinded researcher (physician) will then perform the laceration repair, mYPAS, and post-procedure evaluations. The non-blinded researcher, nurse, parent, and patient will be advised not to disclose which medication(s) were administered to ensure blinding of the provider performing the laceration repair and assessment.