Oral oxycodone plus intravenous acetaminophen versus intravenous morphine sulfate
in acute bone fracture pain control: a double-blind placebo-controlled randomized
clinical trial.
Author(s): Zare MA(1), Ghalyaie AH, Fathi M, Farsi D, Abbasi S, Hafezimoghadam P.
Affiliation(s): Author information:
(1)Emergency Medicine Department, Rasoul-e-Akram Hospital, Iran University of
Medical Sciences, Niyayesh St, Sattarkhan Ave, 14456, Tehran, Iran.
Publication date & source: 2014, Eur J Orthop Surg Traumatol. , 24(7):1305-9
OBJECTIVES: Bone fracture is a common cause of acute pain in emergency and
orthopedics departments. Targeting the multifaceted mechanisms of pain with
combinations of multiple analgesics (multimodal analgesia) can increase the pain
control efforts efficacy and decrease the adverse effects of each medication.
METHODS: One hundred and fifty-three patients with acute bone fracture were
randomly allocated to two groups receiving intravenous morphine sulfate (74
patients) or oral oxycodone plus intravenous acetaminophen (79 patients). Pain
scores and drugs' adverse effects were assessed 10, 30 and 60 min after
treatment.
RESULTS: Pain scores were similar between groups before, 30 and 60 min after
medication but patients in morphine sulfate group experienced less pain 10 min
after medication. Eight (10.8%) patients in morphine sulfate group and 26 (32.9%)
patients in acetaminophen/oxycodone group experienced nausea that was
statistically significant higher (P value = 0.001). Itching was seen in 12
(15.1%) patients of acetaminophen/oxycodone group and three (4.0%) patients of
patients in morphine sulfate group (P value = 0.02).
CONCLUSION: Intravenous acetaminophen plus oral oxycodone is as effective as
intravenous morphine sulfate in acute pain control in emergency department but
with a less desirable safety profile.
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