• Michel Galinski, François Dolveck, Stephen W Borron, Loic Tual, Vincent Van Laer, Jean-Yves Lardeur, Frédéric Lapostolle, and Frédéric Adnet.
• Samu 93-Department of Anesthesiology and Intensive Care, Avicenne Hospital, Bobigny, France. michel.galinski@avc.ap-hop-paris.fr
• Am J Emerg Med. 2005 Mar 1; 23 (2): 114-9.

Study ObjectiveThe aim of this study was to compare, by a randomized double-blind method, morphine (M) and fentanyl (F) in a prehospital setting.MethodsConsecutive patients with severe, acute pain defined as a visual analog scale score (VASS) of 60/100 or higher were included. The M group received an initial intravenous M injection of 0.1 mg/kg then of 3 mg every 5 minutes. The F group received an initial intravenous F injection of 1 microg/kg then of 30 microg every 5 minutes. The goal of analgesia was a VASS of 30/100 or lower. The end point was the VASS measured 30 minutes after initial administration (VAS [T30]).ResultsThere were 26 patients included in the M group and 28 in the F group. Initial VASS(T0) and VASS(T30), mean (95% CI), were 83 (78-88) and 40 (28-52) in the M group and 77 (72-82) and 35 (27-43) in the F group (P=NS). Sixty-two percent of patients in the M group described analgesia as excellent or good vs 76% of those in the F group who did (P=NS). There were no differences in the incidence of side effects in the 2 groups.ConclusionThis study demonstrates that M and F were comparable in treating severe, acute pain in a prehospital setting during the first 30 minutes in spontaneous breathing patients.

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