{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:39:40Z","timestamp":1792636780920,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":90,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"DOI":"10.1186\/s12873-026-01679-5","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:35:03Z","timestamp":1784910903000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A non\u2013inferiority randomized controlled trial comparing nebulized fentanyl and intravenous morphine for acute pain management in the emergency department"],"prefix":"10.1186","volume":"26","author":[{"given":"Pitchapar","family":"Preungprasob","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapeeporn","family":"Rojsaengroeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirakit","family":"Hengrasmee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornsiri","family":"Kanokkarnjana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaowapa","family":"Changya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"1679_CR1","unstructured":"The European Society for Emergency Medicine (EUSEM). Guidelines for the management of acute pain in emergency situations. Belgium. 2020;1\u201392."},{"issue":"12","key":"1679_CR2","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1111\/j.1526-4637.2010.00983.x","volume":"11","author":"R Sinatra","year":"2010","unstructured":"Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010, Dec;11(12):1859\u201371. https:\/\/doi.org\/10.1111\/j.1526-4637.2010.00983.x.","journal-title":"Pain Med"},{"key":"1679_CR3","unstructured":"Anekar AA, Hendrix JM. Cascella M.WHO analgesic Ladder.National Library of Medicine.April 23, 2023. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554435\/."},{"issue":"2","key":"1679_CR4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1080\/10903127.2021.2018073","volume":"27","author":"G Lindbeck","year":"2023","unstructured":"Lindbeck G, Shah MI, Braithwaite S, Powell JR, Panchal AR, Browne LR, et al. Evidence-based Guidelines for Prehospital pain management: recommendations. Prehospital Emerg Care. 2023;27(2):144\u201353. https:\/\/doi.org\/10.1080\/10903127.2021.2018073.","journal-title":"Prehospital Emerg Care"},{"issue":"1","key":"1679_CR5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.5847\/wjem.j.1920-8642.2019.01.004","volume":"10","author":"HSM Vahedi","year":"2019","unstructured":"Vahedi HSM, Hajebi H, Vahidi E, Nejati A, Saeedi M. Comparison between intravenous morphine versus fentanyl in acute pain relief in drug abusers with acute limb traumatic injury. World J Emerg Med. 2019;10(1):27\u201332. https:\/\/doi.org\/10.5847\/wjem.j.1920-8642.2019.01.004.","journal-title":"World J Emerg Med"},{"key":"1679_CR6","unstructured":"Murphy PB, Patel P, Barrett MJ, Library of Medicine. Morphine. In: StatPearls [Internet]. National 2025 Mar 27. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK526115\/. 2025 May 2]."},{"issue":"1\u20132","key":"1679_CR7","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3233\/BME-120735","volume":"23","author":"A Sabri","year":"2013","unstructured":"Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng. 2013;23(1\u20132):93\u2013108. https:\/\/doi.org\/10.3233\/BME-120735.","journal-title":"Biomed Mater Eng"},{"issue":"6","key":"1679_CR8","first-page":"510","volume":"27","author":"K Fleischmann","year":"2011","unstructured":"Fleischmann K, Terkivatan T. Safety and effectiveness of low-dose morphine in acute pain management: a systematic review of current evidence. Clin J Pain. 2011;27(6):510\u201317.","journal-title":"Clin J Pain"},{"issue":"1","key":"1679_CR9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1191\/026921600668793500","volume":"14","author":"G Zeppetella","year":"2000","unstructured":"Zeppetella G. Nebulized and intranasal fentanyl in the management of cancer-related breakthrough pain. Palliat Med. 2000;14(1):57\u201358. https:\/\/doi.org\/10.1191\/026921600668793500.","journal-title":"Palliat Med"},{"issue":"1","key":"1679_CR10","first-page":"63","volume":"49","author":"A Khamtha","year":"2023","unstructured":"Khamtha A, Noitasaeng P, Narungsri A, Sangsai A, Vichitvejpaisal P. Department of anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University and anesthesia Nursing Division, Nakhon Pathom Hospital.Anesthetics administration via nebulization. Thai J Anesthesiol. 2023;49(1):63\u201368.","journal-title":"Thai J Anesthesiol"},{"key":"1679_CR11","unstructured":"Pharmacy and therapeutics committee, Siriraj Hospital.Opioids parenteral and oral.High alert drug. 2022, April, 6;212\u201328. 6th."},{"key":"1679_CR12","unstructured":"PAMI: pain assessment and management initiative. source Pain management & dosing Guide [Internet]. 2020. Available from: https:\/\/pami.emergency.med.jax.ufl.edu\/wordpress\/files\/2020\/09\/PAMI-Dosing-Guide-Nov.2.2020.pdf."},{"issue":"5","key":"1679_CR13","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1213\/ANE.0b013e3182691898","volume":"115","author":"DB Macleod","year":"2012","unstructured":"Macleod DB, Habib AS, Ikeda K, Spyker DA, Cassella J V, Ho KY, et al. Inhaled fentanyl aerosol in healthy volunteers: pharmacokinetics and pharmacodynamics. Anesth Analg. 2012, Nov;115(5):1071\u201377. https:\/\/doi.org\/10.1213\/ANE.0b013e3182691898.","journal-title":"Anesth Analg"},{"issue":"6","key":"1679_CR14","doi-asserted-by":"publisher","first-page":"583","DOI":"10.4103\/0019-5049.123331","volume":"57","author":"AP Singh","year":"2013","unstructured":"Singh AP, Jena SS, Meena RK, Tewari M, Rastogi V. Nebulised fentanyl for post-operative pain relief, a prospective double-blind controlled randomised clinical trial. Indian J Anaesth. 2013, Nov;57(6):583\u201386. https:\/\/doi.org\/10.4103\/0019-5049.123331.","journal-title":"Indian J Anaesth"},{"issue":"3","key":"1679_CR15","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1111\/j.1742-6723.2009.01183.x","volume":"21","author":"JS Furyk","year":"2009","unstructured":"Furyk JS, Grabowski WJ, Black LH. Nebulized fentanyl versus intravenous morphine in children with suspected limb fractures in the emergency department: a randomized controlled trial. Emerg Med Australasia. 2009, Jun;21(3):203\u201309. https:\/\/doi.org\/10.1111\/j.1742-6723.2009.01183.x.","journal-title":"Emerg Med Australasia"},{"issue":"4","key":"1679_CR16","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1197\/aemj.10.4.390","volume":"10","author":"PE Bijur","year":"2003","unstructured":"Bijur PE. Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Academic Emerg Med. 2003;10(4):390\u201392. https:\/\/doi.org\/10.1197\/aemj.10.4.390.","journal-title":"Academic Emerg Med"},{"issue":"7","key":"1679_CR17","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1111\/j.1365-2702.2005.01121.x","volume":"14","author":"A Williamson","year":"2005","unstructured":"Williamson A, Hoggar B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798\u2013804. https:\/\/doi.org\/10.1111\/j.1365-2702.2005.01121.x.","journal-title":"J Clin Nurs"},{"issue":"19","key":"1679_CR18","doi-asserted-by":"publisher","first-page":"2901","DOI":"10.3748\/wjg.v10.i19.2901","volume":"10","author":"SD Wu","year":"2004","unstructured":"Wu SD, Zhang ZH, Jin JZ, Kong J, Wang W, Zhang Q, et al. Effects of narcotic analgesic drugs on human Oddi\u2019s sphincter motility. World J Gastroenterol. 2004, Oct, 1;10(19):2901\u201304.","journal-title":"World J Gastroenterol"},{"issue":"11","key":"1679_CR19","first-page":"681","volume":"6","author":"O Zimmerman","year":"2004","unstructured":"Zimmerman O, Halpern P. Opinion survey of analgesia for abdominal pain in Israeli emergency departments. Isr Med Assoc J. 2004, Nov;6(11):681\u201385. PMID: 15562806.","journal-title":"Isr Med Assoc J"},{"issue":"1","key":"1679_CR20","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.annemergmed.2007.01.030","volume":"50","author":"C Hashikawa","year":"2007","unstructured":"Hashikawa C, Burke TF, Pallin DJ, Briggs-Malonson M. Analgesia administration for acute abdominal pain: a survey of emergency physicians. Ann Emerg Med. 2007, Jul;50(1):91\u201392. https:\/\/doi.org\/10.1016\/j.annemergmed.2007.01.030.","journal-title":"Ann Emerg Med"},{"issue":"9","key":"1679_CR21","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/j.ajem.2014.05.051","volume":"32","author":"S Farahmand","year":"2014","unstructured":"Farahmand S, Shiralizadeh S, Talebian M-T, Hariri SB, Arbab M, Basirghafouri H, et al. Nebulized fentanyl vs intravenous morphine for ED patients with acute limb pain: a randomized clinical trial. Am J Emerg Med. 2014, Sep;32(9):1011\u201315. https:\/\/doi.org\/10.1016\/j.ajem.2014.05.051.","journal-title":"Am J Emerg Med"},{"issue":"6","key":"1679_CR22","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1016\/j.ajem.2015.03.046","volume":"33","author":"T Deaton","year":"2015","unstructured":"Deaton T, Auten JD, Darracq MA. Nebulized fentanyl vs intravenous morphine for ED patients with acute abdominal pain: a randomized double-blinded, placebo-controlled clinical trial. Am J Emerg Med. 2015, Jun;33(6):791\u201395. . https:\/\/doi.org\/10.1016\/j.ajem.2015.03.046","journal-title":"Am J Emerg Med"},{"key":"1679_CR23","first-page":"117","volume":"31","author":"B Kulabusaya","year":"2021","unstructured":"Kulabusaya B. Pharmacy department, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University.Analgesic drug use in chronic kidney disease patients. Thai J Hosp Pharm. 2021;31, No 2, May - Aug, 117\u201327.","journal-title":"Thai J Hosp Pharm"},{"issue":"14","key":"1679_CR24","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.2146\/ajhp150893","volume":"74","author":"TM Afolabi","year":"2017","unstructured":"Afolabi TM, Nahata MC, Pai V. Nebulized opioids for the palliation of dyspnea in terminally ill patients. Am J Health-System Pharm. 2017;74(14):1053\u201361. https:\/\/doi.org\/10.2146\/ajhp150893.","journal-title":"Am J Health-System Pharm"}],"container-title":["BMC Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12873-026-01679-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-026-01679-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-026-01679-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:57:02Z","timestamp":1792634222000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12873-026-01679-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1679"],"URL":"https:\/\/doi.org\/10.1186\/s12873-026-01679-5","relation":{},"ISSN":["1471-227X"],"issn-type":[{"value":"1471-227X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"11 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study received ethical approval from the Institutional Review Board of the Faculty of Medicine Vajira Hospital, Navamindradhiraj University (COA No. 010\/2567) and was registered with the Clinical Trial No. TCTR20240624001(The registration date was 21 June2024). The researchers obtained informed consent from all participants. All procedures in this study were performed in accordance with the tenets of the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"284"}}