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The Efficacy of Nebulized Fentanyl versus Intravenous Morphine for Acute Pain Management in Patients with Long Bone Fractures: A Double-Blind Randomized Controlled Trial
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Mohsen Salehi    , Alireza Zeraatchi , Farzaneh Karamitanha , Gholamreza Hamidkholgh * |
| Department of Emergency Medicine, School of Medicine, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran , Hamidkholgh@arums.ac.ir |
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Abstract: (281 Views) |
Background: Effective management of acute pain in patients with long-bone fractures is essential for comfort and procedural facilitation. While intravenous morphine is the gold standard for pain relief, it is associated with significant adverse effects. This study investigates the efficacy and safety of nebulized fentanyl as a noninvasive alternative to intravenous morphine in managing acute pain from long-bone fractures, alongside assessing patient satisfaction.
Methods: In a randomized, double-masked clinical trial conducted in the Emergency Department, 240 patients aged 20–50 years with long-bone fractures and visual analog scale (VAS) pain scores greater than five were randomly assigned to receive either nebulized fentanyl (4 µg/kg) or intravenous morphine (0.1 mg/kg). Pain scores were recorded at baseline and at 5, 10, 15, 30, and 60 minutes after the intervention. Secondary outcomes included the need for rescue analgesia, adverse effects, and patient satisfaction, which were analyzed statistically using a significance level of α = 0.05.
Results: At 5 minutes, the pain intensity difference between groups was Δ5 = x5 units (95% CI: [L5, U5]), and at 60 minutes, Δ60 = x60 units (95% CI: [L60, U60]). The need for rescue analgesia showed numeric differences at 15 and 30 minutes. Nausea/vomiting were more prevalent in the morphine group. Patient satisfaction was comparable between the two groups.
Conclusion: Both nebulized fentanyl and intravenous morphine are effective for acute pain relief, though morphine offers superior early relief. Nebulized fentanyl presents a viable alternative with fewer systemic side effects. |
Article number: 5 |
| Keywords: Acute Pain Management, Long Bone Fractures, Nebulized Fentanyl, Intravenous Morphine, Emergency Care |
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Full-Text [PDF 303 kb]
(82 Downloads)
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Type of Study: article |
Subject:
Pharmacology
Received: 2025/06/21 | Accepted: 2025/08/30 | Published: 2025/11/22
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Ethics code: IR.ZUMS.REC.1398.072
Salehi M, Zeraatchi A, Karamitanha F, Hamidkholgh G. The Efficacy of Nebulized Fentanyl versus Intravenous Morphine for Acute Pain Management in Patients with Long Bone Fractures: A Double-Blind Randomized Controlled Trial. J Ardabil Univ Med Sci 2025; 25 (2) : 5 URL: http://jarums.arums.ac.ir/article-1-2509-en.html
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