Reynolds SL, et al. - Authors here performed a comparison of the tolerability and efficacy of intranasal sub-dissociative ketamine with intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. They encountered more minor side effects with intranasal ketamine administration than intranasal fentanyl. The two approaches resulted in similar pain relief at 20 minutes. The data support the feasibility of a larger, non-inferiority trial to more rigorously evaluate the safety, efficacy, and potential opioid sparing benefits of intranasal ketamine analgesia for children with acute pain.