Abstract

ANALGESIC EFFICACY OF FENTANYL VERSUS MORPHINE IN PATIENTS WITH TRAUMA IN EMERGENCY MEDICINE: META-ANALYSIS

Dalal Fahad AlAnazi*, Shrouq Abdulaziz Almadani, Angham Ghazi Alghidany, Rashed Abdulaziz Boshushah, Majed Talal Algharbi, Mahmoud Talat Khodary, Hatoon Fahd Hakeem, Ghadeer Sadiq Surrati, Majed Rabie Alhamdan, Salman Mesfer Alyaseen, Qusai Sadad Nematallah

Abstract

Background & Purpose: The Morphine has been recommended by way of numerous international guidelines because the opioid of choice in treatment of acute pain. Morphine and fentanyl are powerful opioid analgesics and are the simplest used prehospital, in both combat and civilian settings. The Aim of this work is to provide cumulative data about the analgesic efficacy of fentanyl versus morphine in patients with trauma in emergency. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify ER RCTs, clinical trials, and comparative studies, which studied the outcome of Fentanyl versus Morphine of trauma patients. A meta-analysis was done using fixed and random-effect methods. The primary outcome was pain reduction expressed as difference in scores on the Numeric Rating Scale (NRS). Secondary outcome was rate of adverse effects. Results: A total of 5 studies were identified involving 532 patients, with 272 patients in Fentanyl group, and 260 patients in Morphine group. Regarding primary outcome measures, meta-analysis study showed that, non-significant difference in NRS pain score in Fentanyl as compared to Morphine; P > 0.05). Regarding secondary outcome measure, meta-analysis study showed that, non-significant difference in adverse effects in Fentanyl as compared to Morphine; P > 0.05). Conclusion: To conclude, Fentanyl produced a similar analgesic response to morphine for traumatic accidents in the ED. however, the reaction and redosing changed into greater speedy with fentanyl.

Keywords: Fentanyl, Morphine, Trauma.