In the emergency department, 60% of patients have an acute pain. Appropriate management of acute pain is a public health priority according to who recommendations. Nebulized morphine has been extensively studied in children but less well in adults. It offers a non-invasive route for systemic drug delivery, more rapid and less invasive than intravenous (IV) method.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
200
After randomization, patients will receive 10 mg of morphine (1ml) diluted in 4 ml normal saline and nebulized with 6 l/mn during 10 min. Nebulization will be repeated systematically 3 times every twenty minutes unless the patient pain was resolved (VAPS 30%). In addition, patients receive a bolus of IV placebo(5 ml normal saline . IV placebo (2 ml) will be repeated every 10 minutes if the objective of analgesia was not reached .
After randomization, patients will receive a bolus of 5 mg of IV morphine (5 ml. Then, 2mg of IV morphine (2ml) will be added every 10 minutes if the objective of analgesia was not reached (VAPS \>30%). In addition, normal saline (5ml)is nebulized with 6 l/mn during 10 min and will be repeated systematically every 20 minutes unless the patient's pain was not resolved (VAPS \>30%).
Fattouma Bourguiba University Hospital
Monastir, Monastir Governorate, Tunisia
1. Resolution rate
resolution is defined as VAPS \<30%.
Time frame: one hour
rate of side effects
Dyspnea, cutaneous rush, vomiting, nausea, pruritus and dizziness.
Time frame: one hour
Resolution time
Resolution time is defined as the time between the starting of the protocol and pain decrease to a Visual Analog Scale less than 30%
Time frame: one hour
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