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Title

EFFICACY OF INTRAVENOUS PARACETAMOL VERSUS INTRAVENOUS MORPHINE IN ACUTE LIMB TRAUMA

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Abstract

 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 18 years and older) with acute limb trauma and a pain score of greater than 3/10 in the emergency department were recruited; they received either 1 g intravenous paracetamol or 0.1 mg/kg intravenous MORPHINE sulfate over 15 minutes. The primary outcome was the pain score measured on a numerical rating scale at 0, 15 and 30 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 = 30) or IV MORPHINE (n = 30). The mean reduction in numerical rating scale pain intensity scores at 30 minutes was 3.86 (± 1.61) for paracetamol, and 2.16 (± 1.39) for MORPHINE. However, pain relief was significantly higher in the paracetamol group compared to the MORPHINE group (P < 0.001). Four patients in the paracetamol group and 15 patients in the MORPHINE group needed rescue analgesia and the difference was significant (P = 0.05).Conclusions: Intravenous paracetamol appears to provide better analgesia than intravenous MORPHINE in acute limb trauma. Further larger studies are required.

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