{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:46:14Z","timestamp":1791222374706,"version":"4.1.0"},"reference-count":77,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This systematic review examined the efficacy and safety of intranasal fentanyl (INF) for acute pain treatment in children, adults, and the elderly in prehospital emergency services (PHES) and emergency departments (ED). ClinicalTrials.gov, LILACS, PubMed, SCOPUS, EMBASE, Google Scholar and Cochrane databases were consulted until 31 December 2022. A total of 23 studies were included: 18 in children (1 PHES, 17 ED), 5 in adults (1 PHES, 4 ED) and 1 in older people (1 PHES subgroup analysis). In children, INF was effective in both settings and as effective as the comparator drugs, with no differences in adverse events (AEs); one randomised controlled trial (RCT) showed that INF was more effective than the comparator drugs. In adults, one study demonstrated the efficacy of INF in the PHES setting, one study demonstrated the efficacy of INF in the ED setting, two RCTs showed INF to be less effective than the comparator drugs and one RCT showed INF to be as effective as the comparator, with no difference in AEs reported. In older people, one study showed effective pain relief and no AEs. In summary, INF appears to be effective and safe in children and adults in PHES and ED. More high-quality studies are needed, especially in PHES and older people.<\/jats:p>","DOI":"10.3390\/jcm12072609","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T01:37:02Z","timestamp":1680226622000},"page":"2609","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Intranasal Fentanyl for Acute Pain Management in Children, Adults and Elderly Patients in the Prehospital Emergency Service and in the Emergency Department: A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9281-3601","authenticated-orcid":false,"given":"Sossio","family":"Serra","sequence":"first","affiliation":[{"name":"Emergency Department, Maurizio Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-327X","authenticated-orcid":false,"given":"Michele Domenico","family":"Spampinato","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and for Romagna, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Riccardi","sequence":"additional","affiliation":[{"name":"Pronto Soccorso Ospedale di Imperia, 18100 Imperia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Guarino","sequence":"additional","affiliation":[{"name":"UOC MEU Ospedale CTO- AORN dei Colli Napoli, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-9711","authenticated-orcid":false,"given":"Rita","family":"Pavasini","sequence":"additional","affiliation":[{"name":"UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9837-4638","authenticated-orcid":false,"given":"Andrea","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Emergency Department, AUSL Romagna, Presidio Ospedaliero Morgagni-Pierantoni, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"De Iaco","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Medicina di Emergenza Urgenza Ospedale Maria Vittoria, ASL Citt\u00e0 di Torino, 10144 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"ref_1","first-page":"482","article-title":"Prehospital pain management","volume":"7","author":"Wesley","year":"2003","journal-title":"Prehosp. Emerg. Care."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1053\/ajem.2002.32643","article-title":"The high prevalence of pain in emergency medical care","volume":"20","author":"Cordell","year":"2002","journal-title":"Am. J. Emerg. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.ajem.2010.06.031","article-title":"Out-of-hospital emergency medicine in pediatric patients: Prevalence and management of pain","volume":"29","author":"Galinski","year":"2011","journal-title":"Am. J. Emerg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/S0736-4679(98)00012-2","article-title":"One-week survey of pain intensity on admission to and discharge from the emergency department: A pilot study","volume":"16","author":"Johnston","year":"1998","journal-title":"J. Emerg. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1590\/S1807-59322007000500010","article-title":"The \u201coligoanalgesia problem\u201d in the emergency care","volume":"62","author":"Calil","year":"2007","journal-title":"Clinics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/0735-6757(89)90286-6","article-title":"Oligoanalgesia in the emergency department","volume":"7","author":"Wilson","year":"1989","journal-title":"Am. J. Emerg. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1017\/S1481803500007478","article-title":"Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments","volume":"4","author":"Todd","year":"2002","journal-title":"CJEM"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.jemermed.2019.09.018","article-title":"Analgesia Use in Children with Acute Long Bone Fractures in the Pediatric Emergency Department","volume":"58","author":"Noble","year":"2020","journal-title":"J. Emerg. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.tjem.2017.08.001","article-title":"Determinants of inappropriate acute pain management in old people unable to communicate verbally in the emergency department","volume":"17","author":"Allione","year":"2017","journal-title":"Turk. J. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0735-6757(96)90123-0","article-title":"Age as a risk factor for inadequate emergency department analgesia","volume":"14","author":"Jones","year":"1996","journal-title":"Am. J. Emerg. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jemermed.2014.12.043","article-title":"Oligoanalgesia in blunt geriatric trauma","volume":"48","author":"Quattromani","year":"2015","journal-title":"J. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.annemergmed.2003.11.019","article-title":"Inadequate analgesia in emergency medicine","volume":"43","author":"Rupp","year":"2004","journal-title":"Ann. Emerg. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0196-0644(94)70031-1","article-title":"Emergency department analgesia use in pediatric trauma victims with fractures","volume":"23","author":"Friedland","year":"1994","journal-title":"Ann. Emerg. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1080\/10903120801907471","article-title":"Prehospital pain assessment in pediatric trauma","volume":"12","author":"Izsak","year":"2008","journal-title":"Prehospital Emerg. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/bioe.12170","article-title":"Why is Pain Still Under-Treated in the Emergency Department? Two New Hypotheses","volume":"30","author":"Carter","year":"2016","journal-title":"Bioethics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2147\/PPA.S7665","article-title":"Intranasal fentanyl for pain control: Current status with a focus on patient considerations","volume":"5","author":"Prommer","year":"2011","journal-title":"Patient Prefer. Adherence"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1002\/jps.2600760709","article-title":"Analysis of structure requirements for the absorption of drugs and macromol-ecules from the nasal cavity","volume":"76","author":"McMartin","year":"1987","journal-title":"J. Pharm. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1034\/j.1399-6576.2002.460702.x","article-title":"Nasal administration of opioids for pain management in adults","volume":"46","author":"Dale","year":"2002","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_19","first-page":"261","article-title":"Mechanism of nasal absorption of drugs","volume":"292","author":"Hussain","year":"1989","journal-title":"Prog. Clin. Biol. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jpainsymman.2012.07.009","article-title":"Intranasal fentanyl in the palliative care of newborns and infants","volume":"46","author":"Harlos","year":"2013","journal-title":"J. Pain Symptom. Manag."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"415","DOI":"10.3109\/10611869808997870","article-title":"Nasal route for direct delivery of solutes to the central nervous system: Fact or fic- tion?","volume":"5","author":"Mathison","year":"1998","journal-title":"J. Drug Target."},{"key":"ref_22","first-page":"449","article-title":"Transport of cephalexin to the cerebro-spinal fluid directly from the nasal cavity","volume":"436","author":"Sakane","year":"1991","journal-title":"J. Pharm. Pharmacol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1124\/jpet.103.063222","article-title":"Brain uptake of the glucagon-like peptide-1 antagonist exendin after intranasal administration","volume":"309","author":"Banks","year":"2004","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/BF02527870","article-title":"Pharmacokinetics of intranasal fentanyl","volume":"7","author":"Striebel","year":"1993","journal-title":"Schmerz"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1586\/era.10.77","article-title":"Intranasal fentanyl: From pharmacokinetics and bioavailability to current treatment applications","volume":"10","author":"Panagiotou","year":"2010","journal-title":"Expert Rev. Anticancer. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/s00228-007-0444-8","article-title":"Early pharmacokinetics of nasal fentanyl: Is there a significant arterio-venous difference?","volume":"64","author":"Moksnes","year":"2008","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1345\/aph.1L168","article-title":"Pharmacokinetics and pharmacodynamics of intranasal versus intravenous fentanyl in patients with pain aNer oral surgery","volume":"42","author":"Foster","year":"2008","journal-title":"Ann. Pharmacother."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1002\/jppr200333159","article-title":"Pharmacokinetics of nasal fentanyl","volume":"33","author":"Lim","year":"2003","journal-title":"J. Pharm. Pract. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1046\/j.1365-2044.2003.03286.x","article-title":"A new formulation of nasal fentanyl spray for postoperative analgesia: A pilot study","volume":"58","author":"Paech","year":"2003","journal-title":"Anaesthesia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1046\/j.1442-2026.1999.00020.x","article-title":"A prospective randomized pilot comparison of intranasal fentanyl and intramuscular morphine for analgesia in children presenting to the emergency department with clinical fractures","volume":"11","author":"Younge","year":"1999","journal-title":"Emerg Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.annemergmed.2006.06.016","article-title":"A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department","volume":"49","author":"Borland","year":"2007","journal-title":"Ann. Emerg. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1553-2712.2009.00636.x","article-title":"The implementation of intranasal fentanyl for children in a mixed adult and pediatric emergency department reduces time to analgesic administration","volume":"17","author":"Holdgate","year":"2010","journal-title":"Acad. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.annemergmed.2013.10.025","article-title":"Safety of intranasal fentanyl in the out-of-hospital setting: A prospective observational study","volume":"63","author":"Karlsen","year":"2014","journal-title":"Ann. Emerg. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.ajem.2007.02.027","article-title":"A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting","volume":"25","author":"Rickard","year":"2007","journal-title":"Am. J. Emerg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3109\/10903127.2010.497896","article-title":"Effectiveness of morphine, fentanyl, and methoxyflurane in the prehospital setting","volume":"14","author":"Middleton","year":"2010","journal-title":"Prehosp. Emerg. Care."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (minors): Development and validation of a new instrument","volume":"73","author":"Slim","year":"2003","journal-title":"ANZ J. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1097\/MEJ.0000000000000389","article-title":"Intranasal fentanyl for the prehospital management of acute pain in children","volume":"24","author":"Murphy","year":"2017","journal-title":"Eur. J. Emerg. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Akinsola, B., Hagbom, R., Zmitrovich, A., Kavanagh, P.L., Ashkouti, A., Simon, H.K., Fleming, A., Jain, S., Dampier, C., and Morris, C.R. (2018). Impact of Intranasal Fentanyl in Nurse Initiated Protocols for Sickle Cell Vaso-occlusive Pain Episodes in a Pediatric Emergency Department. Am. J. Hematol., ahead of print.","DOI":"10.1002\/ajh.25144"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e447","DOI":"10.1097\/PEC.0000000000002627","article-title":"The Safety of High-Dose Intranasal Fentanyl in the Pediatric Emergency Department","volume":"38","author":"Anderson","year":"2022","journal-title":"Pediatr. Emerg. Care."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/j.1742-6723.2009.01216.x","article-title":"Intranasal fentanyl in 1-3-year-olds: A prospective study of the effectiveness of intranasal fentanyl as acute analgesia","volume":"21","author":"Cole","year":"2009","journal-title":"Emerg. Med. Australas."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1742-6723.2010.01257.x","article-title":"Does the standard intravenous solution of fentanyl (50 microg\/mL) administered intranasally have analgesic efficacy?","volume":"22","author":"Crellin","year":"2010","journal-title":"Emerg. Med. Australas."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1136\/emj.2008.070474","article-title":"Intranasal fentanyl for analgesia in the paediatric emergency department","volume":"27","author":"Finn","year":"2010","journal-title":"Emerg. Med. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/j.ajem.2017.11.015","article-title":"Intranasal fentanyl improves time to analgesic delivery in sickle cell pain crises","volume":"36","author":"Kelly","year":"2018","journal-title":"Am. J. Emerg. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/PEC.0000000000001017","article-title":"Intranasal Analgesia and Sedation in Pediatric Emergency Care-A Prospective Observational Study on the Implementation of an Institutional Protocol in a Tertiary Children\u2019s Hospital","volume":"35","author":"Nemeth","year":"2019","journal-title":"Pediatr Emerg Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1111\/j.1553-2712.2010.00905.x","article-title":"Use of intranasal fentanyl for the relief of pediatric orthopedic trauma pain","volume":"17","author":"Saunders","year":"2010","journal-title":"Acad. Emerg. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1016\/j.ajem.2015.08.050","article-title":"Time to opioid administration after implementation of an intranasal fentanyl protocol","volume":"33","author":"Schaefer","year":"2015","journal-title":"Am. J. Emerg. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1111\/j.1742-6723.2011.01391.x","article-title":"Equivalency of two concentrations of fentanyl administered by the intranasal route for acute analgesia in children in a paediatric emergency department: A randomized controlled trial","volume":"23","author":"Borland","year":"2011","journal-title":"Emerg. Med. Australas."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e26332","DOI":"10.1002\/pbc.26332","article-title":"Intranasal fentanyl for initial treatment of vaso-occlusive crisis in sickle cell disease","volume":"64","author":"Fein","year":"2017","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1001\/jamapediatrics.2018.4582","article-title":"Effect of Intranasal Ketamine vs Fentanyl on Pain Reduction for Extremity Injuries in Children: The PRIME Randomized Clinical Trial","volume":"173","author":"Frey","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.annemergmed.2014.09.024","article-title":"The PICHFORK (Pain in Children Fentanyl or Ketamine) trial: A randomized controlled trial comparing intranasal ketamine and fentanyl for the relief of moderate to severe pain in children with limb injuries","volume":"65","author":"Graudins","year":"2015","journal-title":"Ann. Emerg. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/PEC.0000000000001556","article-title":"Analgesic Efficacy of Intranasal Ketamine Versus Intranasal Fentanyl for Moderate to Severe Pain in Children: A Prospective, Randomized, Double-Blind Study","volume":"37","author":"Quinn","year":"2021","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1111\/acem.13313","article-title":"Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures","volume":"24","author":"Reynolds","year":"2017","journal-title":"Acad. Emerg. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/PEC.0000000000002779","article-title":"Intranasal Fentanyl to Reduce Pain and Improve Oral Intake in the Management of Children With Painful Infectious Mouth Lesions","volume":"38","author":"Ruffin","year":"2022","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1080\/10903127.2019.1704323","article-title":"Intranasal Fentanyl versus Subcutaneous Fentanyl for Pain Management in Prehospital Patients with Acute Pain: A Retrospective Analysis","volume":"24","author":"Tanguay","year":"2020","journal-title":"Prehosp. Emerg. Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ajem.2022.11.026","article-title":"IF IM in a crisis: Intranasal fentanyl versus intravenous morphine in adult vaso-occlusive crisis","volume":"64","author":"Assad","year":"2023","journal-title":"Am. J. Emerg. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"407","DOI":"10.11604\/pamj.2015.20.407.6010","article-title":"Does intranasal fentanyl provide efficient analgesia for renal colic in adults?","volume":"20","author":"Belkouch","year":"2015","journal-title":"Pan. Afr. Med. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/jrms.JRMS_505_20","article-title":"Intranasal ketamine versus intranasal fentanyl on pain management in isolated traumatic patients","volume":"27","author":"Shokoohi","year":"2022","journal-title":"J. Res. Med. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1016\/j.ajem.2019.158483","article-title":"Atomized intranasal vs intravenous fentanyl in severe renal colic pain management: A randomized single-blinded clinical trial","volume":"38","author":"Nazemian","year":"2020","journal-title":"Am. J. Emerg. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1213\/ANE.0000000000004788","article-title":"Prediction of Opioid-Induced Respiratory Depression on Inpatient Wards Using Continuous Capnography and Oximetry: An International Prospective, Observational Trial","volume":"131","author":"Khanna","year":"2020","journal-title":"Anesth Analg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/ACO.0000000000000541","article-title":"Risk factors for opioid-induced respiratory depression and failure to rescue: A review","volume":"31","author":"Gupta","year":"2018","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jpain.2007.09.006","article-title":"Pain and stress in a systems perspective: Reciprocal neural, endocrine, and immune interactions","volume":"9","author":"Chapman","year":"2008","journal-title":"J. Pain"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1002\/jclp.20816","article-title":"Pain and emotion: A biopsychosocial review of recent research","volume":"67","author":"Lumley","year":"2011","journal-title":"J. Clin. Psychol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1126\/science.288.5472.1769","article-title":"Psychological and neural mechanisms of the affective dimension of pain","volume":"288","author":"Price","year":"2000","journal-title":"Science"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.neubiorev.2017.09.018","article-title":"Route of placebo administration: Robust placebo effects in laboratory and clinical settings","volume":"83","author":"Liu","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1111\/j.1553-2712.2000.tb02061.x","article-title":"Patients\u2019 perceptions of route of nonsteroidal anti-inflammatory drug administration and its effect on analgesia","volume":"7","author":"Schwartz","year":"2000","journal-title":"Acad. Emerg. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/j.pain.0000000000002365","article-title":"Different routes of administration in chronic migraine prevention lead to different placebo responses: A meta-analysis","volume":"163","author":"Swerts","year":"2022","journal-title":"Pain"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.jpainsymman.2010.08.016","article-title":"Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: A systematic literature review","volume":"41","author":"Hjermstad","year":"2011","journal-title":"J. Pain Symptom Manag."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1002\/ejp.1810","article-title":"The mediating effect of pain catastrophizing on pain intensity: The influence of the timing of assessments","volume":"25","author":"Rizzo","year":"2021","journal-title":"Eur. J. Pain"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/AJP.0000000000000429","article-title":"What Determines Whether a Pain is Rated as Mild, Moderate, or Severe? The Importance of Pain Beliefs and Pain Interference","volume":"33","author":"Jensen","year":"2017","journal-title":"Clin. J. Pain"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jpain.2015.01.004","article-title":"Quality of pain intensity assessment reporting: ACTTION systematic review and recommendations","volume":"16","author":"Smith","year":"2015","journal-title":"J. Pain"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1399-6576.2011.02613.x","article-title":"Intranasal fentanyl in the treatment of acute pain--a systematic review","volume":"56","author":"Hansen","year":"2012","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_74","first-page":"CD009942","article-title":"Intranasal fentanyl for the management of acute pain in children","volume":"2014","author":"Murphy","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"341","DOI":"10.2217\/pmt-2018-0016","article-title":"Treatment of pain with intranasal fentanyl in pediatric patients in an acute care setting: A systematic review","volume":"8","author":"Setlur","year":"2018","journal-title":"Pain Manag."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/s13049-021-00974-3","article-title":"The effectiveness and safety of paediatric prehospital pain management: A systematic review","volume":"29","author":"Abebe","year":"2021","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_77","first-page":"205","article-title":"Italian Intersociety Recommendations on pain management in the emergency setting (SIAARTI, SIMEU, SIS 118, AISD, SIARED, SICUT, IRC)","volume":"81","author":"Savoia","year":"2015","journal-title":"Minerva Anestesiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2609\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:07:06Z","timestamp":1760123226000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,30]]},"references-count":77,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12072609"],"URL":"https:\/\/doi.org\/10.3390\/jcm12072609","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,30]]}}}