Pediatric Research Abstract

EFFECTS OF INTRANASAL KETAMINE VS FENTANYL ON PAIN REDUCTION FOR EXTREMITY INJURIES IN CHILDREN Frey TM, Caruso M, Zhang N, Zhang Y, Mittiga MR. JAMA Pediatrics 2018. doi:10.1001/jamapediatrics.2018. This prospective, double-blind, randomized clinical trial sought to compare intranasal ketamine with intranasal fentanyl for pain reduction in a tertiary children's emergency department for children presenting with an extremity injury. The authors state that pain continues to be underdiagnosed and undertreated, especially in children. Furthermore, they also state that theremay be a delay in children obtaining pain medication owing to the need and time to obtain intravenous access. Some children may have a genetic predisposition to diminished opioid sensitivity or an opioid allergy, and there are potential serious adverse effects with opioids. Inclusion criteria included the following: age 8 to 17 years, acute extremity injury, visual analog scale score (VAS) higher than 35 mm (moderate to severe pain), and legal guardian presence. Exclusion criteria included the following: injury to the head, chest, abdomen, or spine;