Efficacy of Intravenous Paracetamol Versus Intravenous Morphine in Acute Limb Trauma

Background: Efficient pain management is one of the most important components of care in the field of emergency medicine. Objectives: This study was conducted to compare intravenous paracetamol and intravenous morphine sulfate for acute pain reduction in patients with limb trauma. Patients and Methods: In a randomized double-blinded clinical trial, all patients (aged ۱۸ years and older) with acute limb trauma and a pain score of greater than ۳/۱۰ in the emergency department were recruited; they received either ۱ g intravenous paracetamol or ۰.۱ mg/ kg intravenous morphine sulfate over ۱۵ minutes. The primary outcome was the pain score measured on a numerical rating scale at ۰, ۱۵ and ۳۰ minutes after commencing drug administration. The requirement for rescue analgesia and the frequency of adverse reactions were also recorded. Results: Sixty patients randomly received either IV paracetamol (n = ۳۰) or IV morphine (n = ۳۰). The mean reduction in numerical rating scale pain intensity scores at ۳۰ minutes was ۳.۸۶ (± ۱.۶۱) for paracetamol, and ۲.۱۶ (± ۱.۳۹) for morphine. However, pain relief was significantly higher in the paracetamol group compared to the morphine group (P < ۰.۰۰۱). Four patients in the paracetamol group and ۱۵ patients in the morphine group needed rescue analgesia and the difference was significant (P = ۰.۰۵). Conclusions: Intravenous paracetamol appears to provide better analgesia than intravenous morphine in acute limb trauma. Further larger studies are required.

Keywords:

analgesics , Acute pain , Acetaminophen , Morphine