Table 2
Author, date and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
Wilson JA et al, UK, 199658 children age 3–16 with suspected limb fractures.PRCTDegree of analgesia at 5, 10, 20 and 30 minNo clinical or statistical differenceSmall numbers
0.1 mg/kg nasal diamorphine v 0.2 mg/kg IM morphineProportion of children with no pain100 v 55%Not blinded
Parental satisfactionp<0.0001
Side effectsnone reported
Kendall JM et al, UK, 2001404 children aged 3 to 16 years with clinical fracture of an upper or lower limb.PRCTDegree of analgesia atClinical significance of different analgesic effect not reported
5 minLess in nasal (p<0.04)
0.1 mg/kg nasal diamorphine v 0.2 mg/kg IM morphine 10 minLess in nasal (p<0.003)
20 minLess in nasal (p<0.002)
30 minNo significant difference
Parental satisfactionGreater in nasal (p<0.0001)
Staff satisfactionGreater in nasal (p<0.0001)
Side effectsNil serious reported