Fentanyl Citrate is commonly used in injectable form and diluted with saline for nasal application. A standard dose of 25 micrograms is applied to each nasal cavity. The preparation involves mixing 1 milliliter of 50 micrograms per milliliter fentanyl with 4 milliliters of saline to make a concentration of 10 micrograms per milliliter. Gauze or cotton is soaked in this solution and inserted into the nose for 24 hours to provide pain relief and reduce bleeding. Continuous monitoring is essential due to the risk of systemic absorption and respiratory depression.

The experimental group receives nasal packing with fentanyl while the control group gets saline. Pain is measured at 1, 2, 4, 8, and 24 hours using a numeric scale from 0 to 10. Patient satisfaction is rated on the same scale. The same medical staff records all data to ensure consistency. Additional pain relief includes intravenous paracetamol and tramadol, given if needed and recorded.

Risks include respiratory depression, sedation, opioid toxicity, allergic reactions, and nasal irritation. A qualified safety officer monitors for adverse effects. Emergency protocols are in place. Adverse effects are reported to the ethics board within 24 hours.

Stopping rules include two or more cases of respiratory depression or one confirmed overdose. Staff are trained in opioid safety and emergency procedures. Data is collected systematically and kept confidential through secure storage and deidentification.