title: Oral oxycodone plus intravenous acetaminophen versus intravenous morphine sulfate in acute bone fracture pain control: a double-blind placebo-controlled randomized clinical trial.
abstract: OBJECTIVE
  Bone fracture is a common cause of acute pain in emergency and orthopedics departments. Targeting the multifaceted mechanisms of pain with combinations of multiple analgesics (multimodal analgesia) can increase the pain control efforts efficacy and decrease the adverse effects of each medication.
  
  
  METHODS
  One hundred and fifty-three patients with acute bone fracture were randomly allocated to two groups receiving intravenous morphine sulfate (74 patients) or oral oxycodone plus intravenous acetaminophen (79 patients). Pain scores and drugs' adverse effects were assessed 10, 30 and 60 min after treatment.
  
  
  RESULTS
  Pain scores were similar between groups before, 30 and 60 min after medication but patients in morphine sulfate group experienced less pain 10 min after medication. Eight (10.8%) patients in morphine sulfate group and 26 (32.9%) patients in acetaminophen/oxycodone group experienced nausea that was statistically significant higher (P value = 0.001). Itching was seen in 12 (15.1%) patients of acetaminophen/oxycodone group and three (4.0%) patients of patients in morphine sulfate group (P value = 0.02).
  
  
  CONCLUSIONS
  Intravenous acetaminophen plus oral oxycodone is as effective as intravenous morphine sulfate in acute pain control in emergency department but with a less desirable safety profile.
authors.affiliation: Emergency Medicine Department, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Niyayesh St, Sattarkhan Ave, 14456, Tehran, Iran.
authors.forename: Mohammad Amin
authors.initials: MA
authors.lastname: Zare
authors.forename: Alireza Hassan
authors.initials: AH
authors.lastname: Ghalyaie
authors.forename: Marzieh
authors.initials: M
authors.lastname: Fathi
authors.forename: Davood
authors.initials: D
authors.lastname: Farsi
authors.forename: Saeed
authors.initials: S
authors.lastname: Abbasi
authors.forename: Peyman
authors.initials: P
authors.lastname: Hafezimoghadam
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000009:adverse effects; D000208:Acute Disease; D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced; D010098:Oxycodone / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011537:Pruritus / Q000139:chemically induced; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D009020:Morphine; D010098:Oxycodone