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1. Administering analgesia sublingually is a suitable option for children with acute abdominal pain in the emergency department.

Author

Cozzi G, Zanchi C, Chiaretti A, Tipo V, Cernich M, D'Anna C, Fantacci C, Conversano E, Zanon D, Ronfani L, and Barbi E

Subjects
Abdominal Pain diagnosis, Acute Disease, Administration, Sublingual, Adolescent, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Child, Child, Preschool, Emergency Service, Hospital, Female, Hospitals, Pediatric, Humans, Italy, Logistic Models, Male, Pain Measurement, Statistics, Nonparametric, Treatment Outcome, Abdominal Pain drug therapy, Acetaminophen administration & dosage, Analgesics, Non-Narcotic therapeutic use, Ketorolac administration & dosage, Tramadol administration & dosage
Abstract

Aim: Acute abdominal pain is a frequent complaint in children attending emergency departments. The aim of this study was to investigate the pain score reductions when children with acute abdominal pain received medication sublingually., Methods: We carried out a multicentre randomised controlled trial in three children's hospitals in Italy between March 2015 and June 2017. Children from four to 18 years of age with acute abdominal pain were recruited if their self-reported pain was at least six on a scale from 0-10. The children were randomised to receive ketorolac 0.5 mg/kg (n = 70) or tramadol 2 mg/kg (n = 70) sublingually or a melt in the mouth powder of 20 mg/kg paracetamol (n = 70). The main study outcome was the pain scores for the three drugs after two hours., Results: The 210 children (58.6% girls) had a median age of 12 years with an interquartile range of 9-14.3. The median pain scores at two hours were not significantly different between ketorolac 2.0 (interquartile ranges, IQR 0.0-4.3) and tramadol 3.0 (IQR 1.0-5.0) vs paracetamol 3.0 (IQR 0.8-5.0). The median pain reductions were all 5.0 points., Conclusion: Delivering analgesia sublingually was a suitable option for pain relief in children with acute abdominal pain in the emergency department., (©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Published
2019
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2. Administering analgesia sublingually is a suitable option for children with acute abdominal pain in the emergency department

Author

Marta Cernich, Davide Zanon, Giorgio Cozzi, Ester Conversano, Chiara Zanchi, Egidio Barbi, Antonio Chiaretti, Vincenzo Tipo, Claudia Fantacci, Carolina D'Anna, Luca Ronfani, Cozzi, Giorgio, Zanchi, Chiara, Chiaretti, Antonio, Tipo, Vincenzo, Cernich, Marta, D'Anna, Carolina, Fantacci, Claudia, Conversano, Ester, Zanon, Davide, Ronfani, Luca, and Barbi, Egidio

Subjects
Male, Acute abdominal pain, Pediatrics, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Interquartile range, Medicine, 030212 general & internal medicine, Child, Children, Tramadol, Pain Measurement, Analgesia, Emergency department, Sublingual, Pediatrics, Perinatology and Child Health, Anti-Inflammatory Agents, Non-Steroidal, General Medicine, Analgesics, Non-Narcotic, Perinatology and Child Health, Hospitals, Pediatric, Treatment Outcome, Italy, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Child, Preschool, Anesthesia, Acute Disease, Female, Emergency Service, Hospital, medicine.drug, Adolescent, Administration, Sublingual, Statistics, Nonparametric, 03 medical and health sciences, 030225 pediatrics, Humans, Administering analgesia, Acetaminophen, Pain score, business.industry, Abdominal Pain, Ketorolac, Logistic Models, business
Abstract

Aim Acute abdominal pain is a frequent complaint in children attending emergency departments. The aim of this study was to investigate the pain score reductions when children with acute abdominal pain received medication sublingually. Methods We carried out a multicentre randomised controlled trial in three children's hospitals in Italy between March 2015 and June 2017. Children from four to 18 years of age with acute abdominal pain were recruited if their self-reported pain was at least six on a scale from 0-10. The children were randomised to receive ketorolac 0.5 mg/kg (n = 70) or tramadol 2 mg/kg (n = 70) sublingually or a melt in the mouth powder of 20 mg/kg paracetamol (n = 70). The main study outcome was the pain scores for the three drugs after two hours. Results The 210 children (58.6% girls) had a median age of 12 years with an interquartile range of 9-14.3. The median pain scores at two hours were not significantly different between ketorolac 2.0 (interquartile ranges, IQR 0.0-4.3) and tramadol 3.0 (IQR 1.0-5.0) vs paracetamol 3.0 (IQR 0.8-5.0). The median pain reductions were all 5.0 points. Conclusion Delivering analgesia sublingually was a suitable option for pain relief in children with acute abdominal pain in the emergency department.

Published
2019

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