According to a study published in the Nov. 7 issue of JAMA, single-dose treatment with ibuprofen and acetaminophen may be as effective as three different opioid and acetaminophen combination analgesics for reducing acute extremity pain in patients who present to the emergency department (ED). 

The researchers conducted a randomized, controlled trial of 416 patients aged 21 to 64 years who presented with moderate to severe acute extremity pain. Patients received either 400 mg of ibuprofen and 1,000 mg of acetaminophen (n = 104), 5 mg of oxycodone and 325 mg of acetaminophen (n = 104), 5 mg of hydrocodone and 300 mg of acetaminophen (n = 104), or 30 mg of codeine and 300 mg of acetaminophen (n = 104). Among 411 patients analyzed, the researchers found that, at 2 hours, mean numerical rating scale (NRS) pain score decreased by 4.3 in the ibuprofen/acetaminophen group, 4.4 in the oxycodone/acetaminophen group, 3.5 in the hydrocodone/acetaminophen group, and 3.9 in the codeine/acetaminophen group. The researchers write that the largest difference in decline in NRS pain score from baseline to 2 hours was between the oxycodone/acetaminophen group and the hydrocodone/acetaminophen group, which was less than the minimum clinically important difference in NRS pain score of 1.3. They suggest that further research to assess adverse events and other dosing may be warranted. Learn more...

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