Nasal diamorphine spray is a safe and effective method of pain relief for young people in acute pain with a limb fracture and should be used in place of morphine by intramuscular injection.This is the conclusion of a study in this week's British Medical Journal (BMJ).
Kendall and colleagues identified 404 patients, aged between 3 and 16 years, attending an emergency department with acute pain resulting from a limb fracture. Within this group, 204 patients were given nasal diamorphine spray and 200 were given intramuscular morphine.
Onset of pain relief was faster in the spray group than in the intramuscular group, with lower pain scores in the spray group at 5, 10 and 20 minutes after treatment, but no difference between the groups after 30 minutes.
Furthermore, 80% of patients given the spray showed no obvious discomfort compared with 9% given intramuscular morphine, and no serious adverse events were seen in patients given the spray.
There should no longer be any reason to give intramuscular morphine to such children, since the spray is appropriate wherever intramuscular morphine is being considered, the authors conclude.
(Reference: Multicentre randomised controlled trial of nasal diamorphine for analgesia in children and teenagers with clinical fractures. BMJ Volume 322, pp 261-265.)
05-Feb-2001
