A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia

Am J Emerg Med. 2005 Mar;23(2):114-9. doi: 10.1016/j.ajem.2004.03.010.


Study objective: The aim of this study was to compare, by a randomized double-blind method, morphine (M) and fentanyl (F) in a prehospital setting.

Methods: Consecutive 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]).

Results: There 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.

Conclusion: This 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Analgesia / methods*
  • Analgesics, Opioid / therapeutic use*
  • Double-Blind Method
  • Emergency Medical Services / methods*
  • Female
  • Fentanyl / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Morphine / therapeutic use*
  • Pain / drug therapy*
  • Pain Measurement
  • Patient Satisfaction
  • Prospective Studies
  • Treatment Outcome


  • Analgesics, Opioid
  • Morphine
  • Fentanyl