title: Paracetamol versus ibuprofen: a randomized controlled trial of outpatient analgesia efficacy for paediatric acute limb fractures.
abstract: Paediatric limb fracture is a common injury that presents frequently to the ED. The primary objective of the present study was to determine whether ibuprofen provides better analgesia than paracetamol for paediatric patients discharged with acute limb fractures. A prospective, randomized controlled study was conducted in a children's ED. Children aged 5-14 years with an acute limb fracture were randomized to be prescribed paracetamol 15 mg/kg/dose every 4 h or ibuprofen 10 mg/kg/dose every 8 h. Objective (child-reported) pain scores using the 'Faces' pain scale were measured over a 48 h period. Child-reported pain did not differ significantly between the paracetamol and ibuprofen groups (mean pain score paracetamol 2.8 [95% CI 2.4-3.4] vs 2.7 [95% CI 2.1-3.3], P = 0.73). Parent-reported sleep quality did not differ between the two groups (P = 0.78). Child-reported pain score decreased over the 48 h of measurement (P < 0.0001). There were no significant differences in side-effects detected between the two groups. The present study shows that in the outpatient paediatric population, ibuprofen does not provide better analgesia than paracetamol. Pain from an acute fracture can be managed by regular simple oral analgesia and immobilization.
authors.affiliation: Children's Emergency Department, Starship Children's Hospital, Auckland District Health Board, Private Bag 92024, Auckland 1142, New Zealand. michaels@adhb.govt.nz
authors.forename: Michael
authors.initials: M
authors.lastname: Shepherd
authors.forename: Richard
authors.initials: R
authors.lastname: Aickin
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000208:Acute Disease; D000293:Adolescent; D000553:Ambulatory Care; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000704:Analysis of Variance; D001134:Arm Injuries / Q000150:complications; D002648:Child; D002675:Child, Preschool; D057186:Comparative Effectiveness Research; D015986:Confounding Factors, Epidemiologic; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007869:Leg Injuries / Q000150:complications; D008297:Male; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D007052:Ibuprofen