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Intranasal fentanyl versus placebo for pain in children during catheterization for voiding cystourethrography

Seen Chung1, Ruth Lim, Ran D Goldman

  • 1Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.

Pediatric Radiology
|February 25, 2010
PubMed

Insights

Intranasal fentanyl did not significantly reduce pain during voiding cystourethrogram (VCUG) catheterization in children aged 4-8. Further research into administration techniques is recommended for pediatric pain management during this common procedure.

Area of Science:

  • Pediatric Urology
  • Pain Management
  • Pharmacology

Background:

  • Voiding cystourethrogram (VCUG) is a common pediatric procedure involving urinary catheterization, often causing pain.
  • Current protocols lack widely adopted non-topical medications to alleviate catheterization pain in children.

Purpose of the Study:

  • To evaluate the efficacy of intranasal (IN) fentanyl compared to placebo (sterile water) in reducing pain during VCUG catheterization in children.
  • To assess the effectiveness of IN fentanyl as a non-topical analgesic for pediatric procedural pain.

Main Methods:

  • A double-blind, randomized controlled trial was conducted with children aged 4-8 years undergoing elective VCUG.
  • Participants received either IN fentanyl (2 microg/kg) or sterile water as a placebo.
  • Pain was assessed using the Face Pain Score-Revised.

Main Results:

  • Children receiving IN fentanyl reported a mean pain score of 2.58 (95% CI: 1.93-3.25).
  • Children receiving sterile water reported a mean pain score of 2.86 (95% CI: 2.20-3.51).
  • No statistically significant difference in pain scores was observed between the IN fentanyl and placebo groups; no adverse events were reported.

Conclusions:

  • Intranasal fentanyl did not demonstrate a statistically significant reduction in pain during VCUG catheterization compared to placebo.
  • Potential factors for the lack of significant difference include administration technique, timing, and the multifactorial nature of distress during VCUG.
  • Future studies should explore alternative IN fentanyl delivery methods for improved analgesia in pediatric procedural pain management.
Abstract

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