Clinical Research Directory

Inclusion Criteria: * Age: 18-65 years * Weight \> 50 kg * Able to provide informed consent * Acute pain (\<48 hours) with verbally administered NRS≥4 (0-10 range, 0 = no - pain and 10 = worst imaginable pain) Exclusion Criteria: * Active peptic ulcer disease (PUD) * History of hypersensitivity to NSAIDs * Pregnancy and breastfeeding * Renal failure * Hepatic failure * Patients who have received analgesics within the past 6 hours * Nasal congestion * Upper respiratory tract infection * Patients with a history of kidney transplantation * Active gastrointestinal bleeding * Systolic blood pressure less than 90 mmHg or greater than 180 mmHg * Heart rate less than 50 per minute or greater than 150 per minute * Concurrent use of NSAIDs or anticoagulant drugs * Inability to provide informed consent * Anatomical abnormalities of the nose or skull base (congenital or acquired) * Hyperreactive airway disease such as severe asthma * Coagulation disorders * Intracranial hemorrhage * Suspected aortic dissection * Suspected rupture of abdominal aortic aneurysm * History of gastrointestinal perforation * Gastrointestinal bleeding within the past month * Chronic pain disorders * Substance misuse * Immediate opioid necessity * Altered mental status * Any pain that is considered to be not appropriate for receiving NSAIDS by emergency physician