title: Randomised comparison of intravenous paracetamol and intravenous morphine for acute traumatic limb pain in the emergency department.
abstract: OBJECTIVE
  To compare the clinical effectiveness of intravenous paracetamol with intravenous morphine in patients with moderate to severe traumatic limb pain.
  
  
  METHODS
  This randomised, double-blind pilot study was conducted in an urban UK emergency department. Patients between 16 and 65 years old with isolated limb trauma and in moderate to severe pain (pain score of 7 or more) received either 1 g intravenous paracetamol or 10 mg intravenous morphine sulphate over 15 min. The primary outcome measure was pain score measured on a visual analogue scale at 0, 5, 15, 30 and 60 min after commencing drug administration. The requirement for rescue analgesia and the frequency of adverse reactions were also recorded.
  
  
  RESULTS
  55 patients were recruited over 10 months. There was no significant difference in analgesic effect between the paracetamol and morphine groups at any time interval. There was no significant difference in the rescue analgesia administered, but there were significantly more adverse reactions in the morphine group.
  
  
  CONCLUSIONS
  Intravenous paracetamol appears to provide a level of analgesia comparable to intravenous morphine in isolated limb trauma. Further larger studies are required.
authors.affiliation: Academic Department of Emergency Care, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Craig
authors.forename: Richard
authors.initials: R
authors.lastname: Jeavons
authors.forename: Joanne
authors.initials: J
authors.lastname: Probert
authors.forename: Jonathan
authors.initials: J
authors.lastname: Benger
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D059787:Acute Pain / Q000188:drug therapy* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005121:Extremities / Q000293:injuries*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D006113:United Kingdom; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D009020:Morphine