Skuse H, Lawlor V. Intranasal diamorphine in children with trauma. Emerg Nurse. 2013 Feb;20(9):14-9. doi: 10.7748/en2013.02.20.9.14.e694. PMID: 23516726.

Abstract

This article discusses the administration of intranasal diamorphine as an analgesia-in paediatric trauma care. The authors outline evidence for its use and discuss a recent multicentre safety study of an intranasal diamorphine product. In addition, they advise emergency department nurses on administering the analgesia, and offer guidelines for determining patient suitability and post-administration assessment.

Blancher M, Maignan M, Clapé C, Quesada JL, Collomb-Muret R, Albasini F, Ageron FX, Fey S, Wuyts A, Banihachemi JJ, Bertrand B, Lehmann A, Bollart C, Debaty G, Briot R, Viglino D. Intranasal sufentanil versus intravenous morphine for acute severe trauma pain: A double-blind randomized non-inferiority study. PLoS Med. 2019 Jul 16;16(7):e1002849. doi: 10.1371/journal.pmed.1002849. PMID: 31310600; PMCID: PMC6634380.

Conclusions: We confirm the non-inferiority of INS compared to IVM for pain reduction at 30 minutes after administration in patients with severe traumatic pain presenting to an emergency department. The IN route, with no need to obtain a venous route, may allow early and effective analgesia in emergency settings and in difficult situations. Confirmation of the safety profile of INS will require further larger studies.

Yves Benisty a écrit : ↑01 août 2022, 13:01 Le deuxième lien ne fonctionne pas.

MORPHINE AEROSOL THERAPY: AN ALTERNATIVE METHOD OF PAIN Poster 225
TREATMENT BLUE Mon-Tuec
J. Meynadier, J. Chrubasik', D. Niv2, E. Geller2
yepartments of>nesthesiology, Centre Oscar Lambre?? France,
University Hospital, CH 8091 ZiirichSwitzerland; Ichiliov
Hospital, Tel Aviv, Israel m
ExhibitHall
Abs No 268

Aim of Investigation. After it was established in dogs that no adverse
effzs <ccurred under morphine inhalation, the method was approved by the
Human Ethics Committee in order to evaluate the analgesic effectiveness and
the pharmacological basis of a postoperative morphine aerosol therapy.

Methods. In 69 patients following cardiac (n = 15, G I; n = 20, G II) and
abdominal (n = 26, G III, n = 8, G IV) surgery, a morphine solution was
administered into the nebulization reservoir within the oxygen supply (5
l/min). Subjective pain (SP; VAS; no pain = 0, worst pain = 10) was recorded
continuously and analgesia maintained with on-demand morphine aerosol
boluses (Gs I and III) or i.v. pethidine (Pi G II). Serum morphine was
determined in Group IV and morphine bioavailability (B) was calculated by
intraindividual comparison of serum morphine after 10 mg nebulized and 10 mg
i.m. morphine.

Results. SP could be maintained around 1 and 3 in Gs I and III,
respectively. Mean postoperative 12 h P requirement in G II was 12.5 mg.
Mean maximum serum morphine of around 12 ng occurred after 46 min following
the beginning of the inhalation treatment. B varied between 9 and 35 %.

Discussion. Our results show that postoperative pain can be effectively
treated with a morphine aerosol. However, due to the great interindividual
difference in absorption the method is not appropriate for routine use.

Discussion. Nos résultats montrent que la douleur postopératoire peut être efficacement traitée avec un aérosol de morphine. Cependant, en raison de la grande différence d'absorption interindividuelle, la méthode n'est pas appropriée pour une utilisation de routine.