An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries

Intra-nasal fentanyl, as an alternative route of analgesic administration, has been shown to be effective particularly in pediatric population and in prehospital setting. Studies on such use among adult patients in emergency department are limited. An open-label study was conducted to evaluate the e...

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Main Author:	Shaharudin , Abdul Aziz
Format:	Thesis
Language:	English
Published:	2016
Subjects:	RM300-666 Drugs and their actions
Online Access:	http://eprints.usm.my/42839/1/Dr._Abdul_Hafiz_Shaharudin-24_pages.pdf
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id	my-usm-ep.42839
record_format	uketd_dc
spelling	my-usm-ep.428392019-04-12T05:25:21Z An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries 2016-05 Shaharudin , Abdul Aziz RM300-666 Drugs and their actions Intra-nasal fentanyl, as an alternative route of analgesic administration, has been shown to be effective particularly in pediatric population and in prehospital setting. Studies on such use among adult patients in emergency department are limited. An open-label study was conducted to evaluate the effectiveness of adding 1.5 mcg/kg intranasal fentanyl on top of 2 mg/kg intravenous tramadol (FENTANYL_TRAMADOL, n=10) as compared to 2 mg/kg intravenous tramadol alone (TRAMADOL,n=10) in adult patients with acute musculoskeletal injuries in moderate to severe pain. When analyzed using independent t-test, the mean visual analog scale (VAS) difference between pre and 10 minute post-intervention was found to be 29.8 mm (SD+/-8.4mm) in the FENTANYL_TRAMADOL arm and 19.6 mm (SD+/-9.7mm) in the TRAMADOL arm [t(8) = 2.515, p = 0.022, 95% confidence interval (CI) 1.68 to 18.72 mm]. A significantly greater albeit transient reduction in mean arterial pressure 10 minutes post-intervention was noted in the FENTANYL_TRAMADOL arm as compared to those in the TRAMADOL arm (13.35 mmHg vs 7.65 mmHg, using Mann-Whitney U test with U-value = 21.5; p = 0.029; r= 0.48). Patients in the FENTANYL_TRAMADOL arm also experienced a higher incidence of transient dizziness 10 minutes post-intervention. Although effective, intranasal fentanyl in adult patients may not be ready for primetime as it may result in significant reduction in blood pressure. 2016-05 Thesis http://eprints.usm.my/42839/ http://eprints.usm.my/42839/1/Dr._Abdul_Hafiz_Shaharudin-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia School of Medical Sciences
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RM300-666 Drugs and their actions
spellingShingle	RM300-666 Drugs and their actions Shaharudin , Abdul Aziz An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
description	Intra-nasal fentanyl, as an alternative route of analgesic administration, has been shown to be effective particularly in pediatric population and in prehospital setting. Studies on such use among adult patients in emergency department are limited. An open-label study was conducted to evaluate the effectiveness of adding 1.5 mcg/kg intranasal fentanyl on top of 2 mg/kg intravenous tramadol (FENTANYL_TRAMADOL, n=10) as compared to 2 mg/kg intravenous tramadol alone (TRAMADOL,n=10) in adult patients with acute musculoskeletal injuries in moderate to severe pain. When analyzed using independent t-test, the mean visual analog scale (VAS) difference between pre and 10 minute post-intervention was found to be 29.8 mm (SD+/-8.4mm) in the FENTANYL_TRAMADOL arm and 19.6 mm (SD+/-9.7mm) in the TRAMADOL arm [t(8) = 2.515, p = 0.022, 95% confidence interval (CI) 1.68 to 18.72 mm]. A significantly greater albeit transient reduction in mean arterial pressure 10 minutes post-intervention was noted in the FENTANYL_TRAMADOL arm as compared to those in the TRAMADOL arm (13.35 mmHg vs 7.65 mmHg, using Mann-Whitney U test with U-value = 21.5; p = 0.029; r= 0.48). Patients in the FENTANYL_TRAMADOL arm also experienced a higher incidence of transient dizziness 10 minutes post-intervention. Although effective, intranasal fentanyl in adult patients may not be ready for primetime as it may result in significant reduction in blood pressure.
format	Thesis
qualification_level	Master's degree
author	Shaharudin , Abdul Aziz
author_facet	Shaharudin , Abdul Aziz
author_sort	Shaharudin , Abdul Aziz
title	An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
title_short	An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
title_full	An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
title_fullStr	An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
title_full_unstemmed	An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
title_sort	open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries
granting_institution	Universiti Sains Malaysia
granting_department	School of Medical Sciences
publishDate	2016
url	http://eprints.usm.my/42839/1/Dr._Abdul_Hafiz_Shaharudin-24_pages.pdf
_version_	1747821111699046400

An open label randomized controlled trial on the efficacy of adding intranasal fentanyl to intravenous tramadol in patients with moderate to severe pain following acute musculoskeletal injuries

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