Needle-Free Nasal Spray Shows Promise for Pediatric Emergency Pain
A nasal spray combining sufentanil and ketamine was tested as a needle-free pain treatment for children in emergency departments. The study enrolled 152 children aged 1 to 17 with moderate to severe pain across seven hospitals in the UK and Spain, mostly for limb injuries, burns, or soft tissue injuries. Doses were adjusted by weight using the number of sprays, and pain and side effects were checked after 15 and 30 minutes.
The trial took place at seven emergency departments across the UK and Spain from May 2024 to May 2025. It involved 152 children aged 1–17 with moderate to severe pain, mostly from limb injuries such as fractures or dislocations, plus burns and soft tissue injuries.
Participants received sufentanil and ketamine through a nasal spray. The number of sprays varied by body weight. At 15 minutes, 54% reported less pain; at 30 minutes, 88% did, with 86.2% experiencing roughly halved pain. Side effects were mild, including nausea, vomiting, dizziness, and nasal itching.
If approved, this needle-free option may ease distress for children and caregivers in emergency settings, especially where intravenous access is difficult or frightening. Clinicians could gain a rapid, weight-adjusted alternative when few pediatric options exist. Health systems may benefit from simpler administration, though cost, availability, monitoring, and real-world safety remain to be seen. This could influence pediatric emergency care and family experience, but not replace clinical judgment.