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Fentanyl in prehospital RSI for TBI linked to lower mortality

Association between fentanyl use and mortality during prehospital emergency anaesthesia in traumatic brain injury – a retrospective cohort study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · Added 8 September 2026

In 423 TBI patients intubated by a Finnish HEMS unit, fentanyl as an anaesthetic adjuvant was associated with lower mortality (OR 0.38), though selection bias can't be excluded.

Study type

Cohort

Design

Retrospective single-HEMS cohort with logistic regression

Participants

423 intubated TBI patients (353 fentanyl, 70 no fentanyl), single Finnish HEMS unit, 2014–2022

Main finding

Fentanyl use was associated with lower mortality before discharge (OR 0.376, 95% CI 0.172–0.823, p=0.014); more post-intubation blood pressure decreases (48% vs 30% at 10% threshold) but fewer increases (18% vs 41%) in the fentanyl group.

Caveat

Substantial baseline differences suggest treatment selection bias may partly explain the finding

Bottom line

Hypothesis-generating

Learning goal

Weigh the benefits and risks of fentanyl as an anaesthetic adjuvant when facilitating intubation in traumatic brain injury.

More

• Topic: Trauma
• Daily scan: 8 September 2026

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