Pain research & management
Use of Intranasal Analgesia for Acute Pain in Pediatric Emergency Departments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
By Alsabri M, Mahmoud YA, Rath S and 6 others.
Abstract
Background
Pain is one of the most common reasons for presentation to pediatric emergency departments, yet timely and effective analgesia remains inconsistently delivered. Intranasal (IN) analgesics offer a noninvasive alternative to injectable routes, but their comparative effectiveness, safety, and acceptability across agents and routes remain incompletely defined.
Methods
We conducted a systematic review and network meta-analysis of randomized controlled trials evaluating IN analgesics for acute pain management in children aged 0-18 years presenting to emergency or prehospital settings. Eligible trials compared IN agents with alternative IN formulations, intravenous, intramuscular, oral analgesics, or placebo. Pain reduction measured using validated pediatric pain scales at predefined timepoints was the primary outcome. Secondary outcomes included need for rescue analgesia, adverse events, acceptability, and emergency department length of stay.