Administering analgesia sublingually is a suitable option for children with acute abdominal pain in the emergency department

Giorgio Cozzi, Chiara Zanchi, Antonio Chiaretti, Vincenzo Tipo, Marta Cernich, Carolina D'Anna, Claudia Fantacci, Ester Conversano, Davide Zanon, Luca Ronfani, Egidio Barbi

Research output: Contribution to journalArticlepeer-review


Aim: Acute abdominal pain is a frequent complaint in children attending emergency departments. The aim of this study was to investigate the pain score reductions when children with acute abdominal pain received medication sublingually. Methods: We carried out a multicentre randomised controlled trial in three children's hospitals in Italy between March 2015 and June 2017. Children from four to 18 years of age with acute abdominal pain were recruited if their self-reported pain was at least six on a scale from 0–10. The children were randomised to receive ketorolac 0.5 mg/kg (n = 70) or tramadol 2 mg/kg (n = 70) sublingually or a melt in the mouth powder of 20 mg/kg paracetamol (n = 70). The main study outcome was the pain scores for the three drugs after two hours. Results: The 210 children (58.6% girls) had a median age of 12 years with an interquartile range of 9–14.3. The median pain scores at two hours were not significantly different between ketorolac 2.0 (interquartile ranges, IQR 0.0–4.3) and tramadol 3.0 (IQR 1.0–5.0) vs paracetamol 3.0 (IQR 0.8–5.0). The median pain reductions were all 5.0 points. Conclusion: Delivering analgesia sublingually was a suitable option for pain relief in children with acute abdominal pain in the emergency department.

Original languageEnglish
Pages (from-to)143-148
Number of pages6
JournalActa Paediatrica, International Journal of Paediatrics
Issue number1
Publication statusPublished - Jan 1 2019


  • Acute abdominal pain
  • Analgesia
  • Children
  • Emergency department
  • Sublingual

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


Dive into the research topics of 'Administering analgesia sublingually is a suitable option for children with acute abdominal pain in the emergency department'. Together they form a unique fingerprint.

Cite this