Efficacy of Intranasal Fentanyl at Reducing Pain During Abscess Incision and Drainage (I&D) in Children

Exclusion Criteria

• •Patient's parent doesn't speak English or Spanish
• •Patient has developmental delay or neurological impairment
• •Patient has altered mental status
• •Known hypersensitivity to study drugs (fentanyl, morphine sulfate, lidocaine, LMX4®)
• •The presence of significant blood or mucous in the nares despite blowing nose or suctioning
• •Severe renal or liver dysfunction, signs of respiratory distress or depression, any respiratory distress, chronic and severe asthma, upper airway obstruction, suspected gastrointestinal obstruction, suspected paralytic ileus
• •Narcotic analgesia within 4 hours of ED physician evaluation
• •Need for moderate sedation, deep sedation, or general anesthesia
• •Need for subspecialty consultation to perform the I\&D
• •Need for I\&D of more than 1 skin abscess
• •Cutaneous abscesses located on the genitals, breasts, face, or neck
• •Previous enrollment in the study
• •Patients with chronic pain syndromes (sickle cell disease, cancer, arthritis, inflammatory bowel disease)