Intranasal sufentanil given in the emergency department triage zone for severe acute traumatic pain—a randomized double-blind controlled trail: comment

  • Simon-Pierre CorcosteguiEmail author
  • Damien Commeau
  • Julien Galant
  • Fabien Ramon
  • Cédric Boutillier du Retail

Dear editor,

We read with great interest the article by Lemoel et al. [1] previously published online in Internal and Emergency Medicine. This paper evaluated whether a single dose of intranasal (IN) sufentanil delivered in the triage zone of an emergency department would improve the management of severely painful adult patients with a limb injury (LI), receiving an intravenous (IV) multimodal analgesia (including opioids if needed). The authors considered IN analgesia in case of delayed care in an overcrowded emergency department. As military physicians, we would like to share our experience of IN analgesia in another context: i.e. tactical medicine.

The first special medical unit (French 1st AMS) provides tactical emergency medical support during Gendarmerie Nationale Intervention Group's (GIGN) operations. GIGN is a French counter-terrorism unit specializing in neutralizing terrorists on the national territory. A tactical medical team composed of a physician-nurse pair joins every...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent



  1. 1.
    Lemoel F, Contenti J, Cibiera C, Rapp J, Occelli C, Levraut J (2019) Intranasal sufentanil given in the emergency department triage zone for severe acute traumatic pain: a randomized double-blind controlled trial. Intern Emerg Med. Google Scholar
  2. 2.
    Pasquier P, Dubost C, Boutonnet M et al (2014) Predeployment training for forward medicalisation in a combat zone: the specific policy of the French military health service. Injury 45:1307–1311CrossRefGoogle Scholar
  3. 3.
    Service médical du RAID, Antenne médicale spécialisée de Satory (GIGN), Lapostolle F et al (2018) How should prehospital medical unit cope with mass shooting ? Ann Fr Med Urgence 8:316-325Google Scholar
  4. 4.
    Dubecq C, Morand G, Ribaud N et al (2018) Intranasal use in an austere environment, an exemple with Ketamine. Proceedings of Urgences 2018 le Congrès; 2018 Jun 13–15; Paris. Accessed 19 Jan 2019
  5. 5.
    Carli P, Pons F, Levraut J et al (2017) The French emergency medical services after the Paris and Nice terrorist attacks: what have we learnt ? Lancet 390:2735–2738CrossRefGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  • Simon-Pierre Corcostegui
    • 1
    Email author
  • Damien Commeau
    • 1
  • Julien Galant
    • 1
  • Fabien Ramon
    • 1
  • Cédric Boutillier du Retail
    • 1
  1. 1.French Military Medical Service1ère Antenne Médicale SpécialiséeVersaillesFrance

Personalised recommendations