Question Do any of 4 oral combination analgesics (3 with different opioids and 1 opioid-free) provide more effective reduction of moderate to severe acute extremity pain in the emergency department (ED)?
- Study Author(s):
- Andrew K. Chang, MD, MS; Polly E. Bijur, PhD; David Esses, MD; et al
- Journal Name:
- JAMA. 2017;318(17):1661-1667.
- Publication Date:
- November 2017
Findings In this randomized clinical trial of 411 ED patients with acute extremity pain (mean score, 8.7 on the 11-point numerical rating scale), there was no significant difference in pain reduction at 2 hours. Mean pain scores decreased by 4.3 with ibuprofen and acetaminophen (paracetamol); 4.4 with oxycodone and acetaminophen; 3.5 with hydrocodone and acetaminophen; and 3.9 with codeine and acetaminophen.
Meaning For adult ED patients with acute extremity pain, there were no clinically important differences in pain reduction at 2 hours with ibuprofen and acetaminophen or 3 different opioid and acetaminophen combination analgesics.
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Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain
in the Emergency Department: A Randomized Clinical Trial