{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:15:47Z","timestamp":1753877747194,"version":"3.41.2"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1171228"],"award-info":[{"award-number":["GNT1171228"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014555","name":"Murdoch Children's Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014555","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Intranasal (IN) fentanyl and nitrous oxide (N<jats:sub>2<\/jats:sub>O) can be combined to provide procedural sedation and analgesia to children. This combination is advantageous because of rapid onset of action and non\u2010parenteral administration, but is associated with increased vomiting. We sought to describe the associations of demographic and procedural factors with early vomiting when using this combination in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a planned secondary analysis of a randomised controlled trial comparing the effect of oral ondansetron <jats:italic>versus<\/jats:italic> placebo at a single paediatric hospital. Children aged 3 to &lt;18\u2009years with planned procedural sedation with IN fentanyl and N<jats:sub>2<\/jats:sub>O were randomised to receive oral ondansetron or placebo prior to N<jats:sub>2<\/jats:sub>O administration. Vomiting was defined as early if occurring during or up to 1\u2009h after N<jats:sub>2<\/jats:sub>O delivery. We assessed the relationship between early vomiting, demographic and procedural characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants were recruited between October 2016 and January 2019 and 62 out of 436 (14%) had early vomiting. The risk of early vomiting was 30% higher with higher total dose of fentanyl, risk ratio\u2009=\u20091.3 (95% confidence interval\u2009= 1.004\u20131.59). There was little evidence of a relationship between the occurrence of early vomiting and sex, age, weight, type of procedure, fasting duration, time between fentanyl administration and start of procedure, and procedure duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that higher doses of IN fentanyl were associated with higher risk of early vomiting when administered with N<jats:sub>2<\/jats:sub>O in children. Other factors did not appear to be associated with vomiting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14497","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T09:24:36Z","timestamp":1726219476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations with early vomiting when using intranasal fentanyl and nitrous oxide for procedural sedation in children: A secondary analysis of a randomised controlled trial"],"prefix":"10.1111","volume":"37","author":[{"given":"Emmanuelle","family":"Fauteux\u2010Lamarre","sequence":"first","affiliation":[{"name":"Emergency Department Cork University Hospital  Cork Ireland"},{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Hearps","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Emergency Department The Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7725-7678","authenticated-orcid":false,"given":"Nuala","family":"Quinn","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Emergency Department Children's Health Ireland at Temple Street  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Anaesthesia and Pain Management The Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Melbourne Children's Trials Centre  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Legge","sequence":"additional","affiliation":[{"name":"Department of Pharmacy The Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine J","family":"Lee","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"},{"name":"Melbourne Children's Trials Centre  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta M","family":"Palmer","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Anaesthesia and Pain Management The Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandy M","family":"Hopper","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Emergency Department The Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1107-2187","authenticated-orcid":false,"given":"Franz E","family":"Babl","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Emergency Department The Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria 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