Nasal Sufentanil-Ketamine Shows Promise for Children's Acute Pain
A phase 2/3 study of 152 children in emergency departments found a fixed-dose intranasal sufentanil-ketamine combination reduced moderate-to-severe acute pain quickly. At 30 minutes, 88% had pain scores of 4 or lower, and most achieved at least 30% pain reduction. Adverse events were mostly mild, with no severe events reported.
The trial tested a fixed-dose nasal formulation combining sufentanil and ketamine in 152 emergency-department patients aged one to under 18 with moderate-to-severe acute pain. It was a phase 2/3 study, and results were presented at the European Emergency Medicine Congress in Paris.
By 15 minutes, 54% of participants had pain scores at or below 4; by 30 minutes, that rose to 88%. At the later point, 95.4% had at least a 30% drop in pain and 86.2% had a 50% drop. Median satisfaction was 5/5, acceptability 92%. Nearly half reported adverse events, mostly mild; no severe events occurred.
If validated further, this approach could affect children with acute pain in emergency settings, their families, and clinicians seeking rapid relief. A well-tolerated nasal option may simplify treatment in busy emergency departments, potentially reducing distress and easing workflow. It could also prompt emergency departments to review pediatric pain protocols, though adoption may depend on regulatory review, cost, and broader safety data.