Intranasal Fentanyl Is Safe in the Prehospital Setting

Prehospital and emergency department providers face a dilemma in wanting to relieve pain while avoiding unnecessary intravenous access, which slows care and in itself is painful. Fentanyl is highly potent, so that small volumes are efficacious and nasal administration is practical. To assess the safety of prehospital fentanyl, investigators prospectively collected data for 904 patients (age range, 7 to 100) who received nasal fentanyl in the prehospital setting during a 2-year period in Denmark.

Patients received doses ranging from 50 to 300 µg for a wide variety of clinical conditions. Clinically relevant pain reduction was achieved in 79% of cases. No important adverse events occurred.