Intranasal Fentanyl and Inhaled Nitrous Oxide for Pediatric Fracture Reduction

In a prospective, observational study conducted at two children's hospitals in Canada and Australia, investigators evaluated the efficacy and safety of intranasal fentanyl plus nitrous oxide (N₂O) for children (age range, 4–18 years) undergoing procedural sedation for reduction of fractures and dislocations. Children with mildly or moderately displaced fractures of the forearm, fractures of the wrist or hand, dislocation of a finger or patella, or displaced femur fractures requiring application of traction were included. Patients received intranasal fentanyl (1.5 µg/kg; 100 µg maximum), with additional doses (0.5 µg/kg) at the discretion of the treating physician. N₂O was self-administered by breathing through the mask as a fixed 50%:50% N_2…