 Studies have shown that the voiding cystourethrogram VCUG can be distressful and painful for children as the child is catheterized during the procedure. Currently no sedation or analgesia is recommended for the procedure. The practice of pediatrics is constantly seeking measures to decrease pain and distress for children. The opioid fentanyl was originally synthesized in the 1950s and 60s as an alternative to morphine and meperidine. The safety and efficacy of intranasal IN fentanyl has been previously demonstrated in the setting of a pediatric emergency department. 