Analgesic Response to Fentanyl in Comparison to Morphine among Adult Traumatic Patients in Emergency Departments: A Randomized Clinical Trial

Several studies have been performed to evaluate the efficacy of different pain management techniques in patients with trauma, using different methods.

To compare Intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects in patients with trauma who were referred to Emergency Department (ED) was investigated.

This double-blind randomized controlled trial (June-December 2017) was performed on adult traumatic patients, who were referred to the EDs of two main trauma centers (Affiliated to Shiraz University of Medical Sciences), in southern Iran. The inclusion criteria were acute pain >4 on a Numeric Rating Scale (NRS) 0-10 upon presentation. The patients were randomly allocated to receive a single dose of IV morphine (0.1 mg/kg) or IV fentanyl (2 µg/kg). The pain score was recorded at baseline, 5, 10, 30, and 120 minutes after administration of either morphine or fentanyl, as well as adverse effects. Then, the data were analyzed.

In order to carry out this study, 167 patients were enrolled. The initial NRS in both groups were similar. The mean ± SD of NRS at all times was higher in the fentanyl group, except in 10 minutes, but only in 120 minutes, this difference was statistically significant (p= 0.01). The mean ± SD of pain reduction in all times was similar in both groups. The incidence of adverse effects in both groups were not different (p = 0.18).

According to findings, IV fentanyl had a similar analgesic effect to IV morphine in traumatic patients with acute pain. Also, there was no significant difference in terms of adverse effects between groups.