{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:51:59Z","timestamp":1791399119016,"version":"4.3.3"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T00:00:00Z","timestamp":1478736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Analgesia administration for children with vaso\u2010occlusive crises is often delayed in the emergency department. Intranasal fentanyl (INF) has been shown to be safe and effective in providing rapid analgesia for other painful conditions. Our objective was to determine if children with a vaso\u2010occlusive crisis (VOC) who received initial treatment with INF compared to placebo achieved a greater decrease in pain score after 20 min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>This was a randomized, double\u2010blind, placebo\u2010controlled trial. Children with sickle cell disease, 3\u201320 years old, not taking daily opiates were eligible for the study. Subjects who presented to the emergency department with a pain score \u22656 were randomized to either a single dose of INF (2\u00a0\u03bcg\/kg, maximum 100\u00a0\u03bcg) or an equivalent volume of intranasal saline. Pain scores were obtained using a modified Wong\u2013Baker FACES pain scale prior to the administration of study drug and at 10, 20, and 30\u00a0min afterward. Additional analgesic medication was given per standard protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010nine subjects completed the study (24 fentanyl and 25 placebo). Subjects who received INF had a greater decrease in median pain score at 20\u00a0min compared to placebo (2 [interquartile range, (IQR) 0.5\u20134] vs. 1 [IQR 0\u20132], <jats:italic>P<\/jats:italic> = 0.048), but not at 10 or 30\u00a0min. There were no serious adverse events in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Children who received INF had a greater decrease in pain score at 20\u00a0min compared to those who received placebo. Further studies should evaluate how to best incorporate INF into the emergency care of a child with a VOC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26332","type":"journal-article","created":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T12:33:54Z","timestamp":1478781234000},"source":"Crossref","is-referenced-by-count":38,"title":["Intranasal fentanyl for initial treatment of vaso\u2010occlusive crisis in sickle cell disease"],"prefix":"10.1002","volume":"64","author":[{"given":"Daniel M.","family":"Fein","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine Department of Pediatrics, Children's Hospital at Montefiore Albert Einstein College of Medicine  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Avner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine Department of Pediatrics, Children's Hospital at Montefiore Albert Einstein College of Medicine  Bronx 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