Nebulized Fentanyl vs. Intravenous Morphine for Abdominal Pain

Fentanyl, a potent opioid with minimal hemodynamic effects, can be delivered by a variety of routes. In a randomized trial, investigators compared nebulized fentanyl (2 µg/kg) and intravenous morphine (0.1 mg/kg) for pain relief in 32 adult emergency department patients with acute abdominal pain. Fentanyl was delivered by a breath-actuated nebulizer designed to prevent release of the drug into the air.

Pain was measured on a visual analog scale at baseline and every 10 minutes for 40 minutes. Pain relief was superior with nebulized fentanyl, with a greater decrease from baseline at all time points. Of patients receiving nebulized fentanyl, 81% reported satisfaction, versus 25% of those receiving intravenous morphine. There were no significan…