Press Release: Nasal spray brings pain relief for children treated in the emergency department

Paris, France: A treatment for pain, that is delivered via a nasal spray, offers an effective, needle-free option for children being seen in the emergency department for a range of injuries, according to research presented at the European Emergency Medicine Congress today (Sunday) [1].

Researchers say that reducing pain quickly and effectively is especially important for children in the emergency department, yet there are currently very few treatment options available.

The research was presented by Professor Shammi Ramlakhan, an emergency medicine consultant working at Sheffield Children’s Hospital, the University of Sheffield and Sheffield Hallam University in the UK.

He said: “Pain in children remains under-recognised and under-treated. Nearly a third of children with moderate to severe pain do not receive adequate pain relief within the 15 to 20 minutes recommended in international guidance. In this study we explored whether a combination of analgesic medication given in a simple dosing system would help provide quick and effective pain relief for children being treated in the emergency department.”

The research included 152 children aged between one and 17 with moderate to severe pain who were being treated at one of seven hospital emergency departments in the UK and Spain between May 2024 and May 2025 [2]. The majority had limb injuries, such as fractures and dislocations, while other children had burns or soft tissue injuries.

All children were given a combination of two pain relief medications, sufentanil and ketamine, via a nasal spray. The dose was adjusted according to the weight of each child by the number of puffs of the nasal spray. Children were assessed 15 minutes after being given the treatment and again after 30 minutes. The researchers used standard assessments to check how much pain children were in and to look for any side effects of the treatment.

After 15 minutes, more than half of the children (54%) were in less pain and after 30 minutes most of the children (88%) children were in less pain. Pain was reduced by around half in the majority of children (86.2%) 30 minutes after treatment. Side effects were mild and included nausea or vomiting, dizziness and nasal itching

Professor Ramlakhan said: “Our research shows that this drug can provide rapid and meaningful pain relief for children being treated in the emergency department. Children tolerated the nose spray well with no major side effects. This is good news for children and their families. This also gives doctors a simple and effective option for treating their patients where very few options currently exist.”

The nasal spray was being tested for the European Medicines Agency (EMA)’s paediatric-use marketing authorisation (PUMA) scheme, which aims to encourage manufacturers to develop and

adapt medications specifically for children. Researchers say the treatment should be available for use in Europe in the near future.

Dr Maša Sorić is a member of the EUSEM abstract selection committee. She is head of the emergency department at University Hospital Merkur, Zagreb, Croatia, and was not involved with the research. She said: “Across Europe, we see millions of children in the emergency department every year. Many of these will be suffering painful injuries. Being in hospital can also be frightening for children and their families.

“This study assesses a nasal spray containing two existing types of pain relief with a very simple dosing system. The results suggest it helps to reduce pain quickly and effectively, without the need for an injection. The treatment did not cause too much drowsiness, and the side effects were mild.

“As doctors we want to give our patients effective treatments, and that includes treatment to reduce any pain they are suffering. However, the pain relief options that are currently available for children are limited at the moment, so we really need more treatments like this in the emergency department.”

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[1] Abstract no: OA099, “Efficacy, Safety and Satisfaction of a Fixed-dose Combination of Intranasal Sufentanil-ketamine (in SUF/kKET) in the Treatment of Acute Pain in Children in the Emergency Department” by Shammi Ramlakhan, Pain Management abstracts session, Sunday 27 September, 14.00-15.30 hrs CEST, Room 152.

[2] Sheffield Children’s Hospital; Birmingham Women’s and Children’s NHS Foundation Trust, and Royal London Hospital in the UK; and Hospital General Universitario Dr. Balmis, Alicante; Hospital Sant Joan de Deu, Barcelona; Universidad Autonoma de Madrid – Hospital Universitario La Paz (HULP), Madrid; and Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, in Spain.

Funding: This study was funded by Cessatech.