There is was a national shortage of Intranasal Diamorphine therefore many departments are now more comfortable using Intranasal Fentanyl as a replacement for rapid provision of opioid analgesia in children.
- Intranasal (IN) fentanyl is a safe, non-invasive and effective analgesic for children with moderate to severe pain
- Fentanyl should be used in combination with non-pharmacological and other pharmacological pain management
- It can be used in conjunction with nitrous oxide for procedural sedation or prior to procedural sedation with ketamine
Dose is 1.5micrograms/Kg for the initial dose and 0.75micrograms/kg 10 minutes later if required.
Drug Delivery
Draw up the appropriate dose plus 0.1ml to allow for the dead space in the Mucosal Atomizer Device
Attach the MAD to the syringe
Sit the child at 45 degrees insert MAD loosely into the nostril and press the plunger
Doses greater than 0.5ml should be split between 2 nostrils
Contraindications
- Blocked nose due to upper respiratory illness or epistaxis
- Respiratory depression
- Hypovolaemia
- Altered consciousness
- Hypersensitivity to fentanyl
- Children below 1 year old
