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14 Articles in Volume 18, Issue #9
Assessing Arthralgia in Children
Children, Opioids, and Pain: The Stats & Clinical Guidelines
How to Fit into a New Practice
How to Talk to Your Chronic Pain Patients
How to Treat Opioid Use Disorder in Pregnant Women
Intranasal Ketamine for Acute Pain in Children
Medication Selection for Comorbid Pain Management (Part 3)
MR Neurography: Using Peripheral Nerve Imaging as a Pain Diagnostic
Naloxone in Schools; Buprenorphine Conversions; OUD Management
Opioid Conversion Calculations and Changes
Pes Anserine Tendino-Bursitis as Primary Cause of Knee Pain in Overweight Women
Self-Management of Chronic Pain in Primary Care
The Homebound Adolescent: Managing Chronic Pain Conditions in the Pediatric Population
The Opioid Band-Aid: The State of Pain Pills, Congressional Bills, and Healthcare in the US

Intranasal Ketamine for Acute Pain in Children

In this Ask the Expert, intranasal fentanyl and intranasal ketamine are compared for treatment of limb injuries.
Pages 27-28
Page 2 of 2


To summarize, neither study found a statistical difference in pain reduction using either intranasal fentanyl or intranasal ketamine. However, when comparing adverse events, ketamine was associated with more frequent events. Due to the inferior safety profile and the similar efficacy of the two trials presented, it does not appear that intranasal ketamine will replace intranasal fentanyl in the treatment of acute, moderate to severe pain in a pediatric population with an extremity injury. Collaboratively, these studies suggest that ketamine could be utilized as an alternative analgesic if there were a contraindication or drug shortage. More research is necessary to establish whether alternative intranasal analgesics have a possible opioid-sparing effect. 

Last updated on: December 3, 2018
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Assessing Arthralgia in Children
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