Are ibuprofen plus acetaminophen as good as opioids in treating acute extremity pain

3.5 out of 5 stars Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial. Chang AK et al. JAMA 2017;318:1661-1667. Abstract As Dr. Demetrios Kyriacou points out in a must-read editorial accompanying this paper, a growing body of evidence clearly indicates that even short-term opioid use for painful injuries or procedures carries a significant risk of leading to chronic use and potential abuse. We are now realizing the importance of avoiding even limited use of drugs such as oxycodone and hydrocodone in opioid-naive patients, if at all possible. The authors carried out randomized double-blind trial in adult patients in the emergency department for acute extremity pain who were scheduled to have the area x-rayed. These patients received one of four oral analgesic regimens: ibuprofen 400-mg + acetaminophen 1000-mg oxycodone 5 mg + acetaminophen 325-mg hydrocodone 5-mg + acetaminophen 300-mg codeine 30-mg + acetaminophen 300-mg The study was done in 2 EDs in the Montefiore Medical System in The Bronx, NY. Patients rated their pain on an 11-point Numeric Rating Scale immediately before analgesics were given and again 1-hour and 2-hours later. A clinically significant difference in pain score was pre-defined as 1.3 points on the NRS scale, based on previous literature. The primary outcome was a between-group difference in pain score decrease at 2 hours. (Interestingly, for reasons not exp...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical acute pain analgesic emergency department opioid Source Type: news