title: Comparison of Intravenous Morphine Versus Paracetamol in Sciatica: A Randomized Placebo Controlled Trial.
abstract: The objective was to compare intravenous morphine and intravenous acetaminophen (paracetamol) for pain treatment in patients presenting to the emergency department with sciatica.
  
  
  
  Patients, between the ages of 21 and 65 years, suffering from pain in the sciatic nerve distribution and a positive straight leg-raise test composed the study population. Study patients were assigned to one of three intravenous interventions: morphine (0.1 mg/kg), acetaminophen (1 g), or placebo. Physicians, nurses, and patients were blinded to the study drug. Changes in pain intensity were measured at 15 and 30 minutes using a visual analog scale. Rescue drug (fentanyl) use and adverse effects were also recorded.
  
  
  
  Three-hundred patients were randomized. The median change in pain intensity between treatment arms at 30 minutes were as follows: morphine versus acetaminophen 25 mm (95% confidence interval [CI] = 20 to 29 mm), morphine versus placebo 41 mm (95% CI = 37 to 45 mm), and acetaminophen versus placebo 16 mm (95% CI = 12 to 20 mm). Eighty percent of the patients in the placebo group (95% CI = 63.0% to 99%), 18% of the patients in the acetaminophen group (95% CI = 10.7% to 28.5%), and 6% of those in the morphine group (95% CI = 2.0% to 13.2%) required a rescue drug. Adverse effects were similar between the morphine and acetaminophen groups.
  
  
  
  Morphine and acetaminophen are both effective for treating sciatica at 30 minutes. However, morphine is superior to acetaminophen.
authors.affiliation: Department of Emergency Medicine, Pamukkale University Hospital, Denizli, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Serinken
authors.affiliation: Department of Emergency Medicine, Akdeniz University Hospital, Antalya, Turkey.
authors.forename: Cenker
authors.initials: C
authors.lastname: Eken
authors.affiliation: Department of Emergency Medicine, Antalya Research and Training Hospital, Antalya, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Gungor
authors.affiliation: Department of Emergency Medicine, Ataturk University Hospital, Erzurum, Turkey.
authors.forename: Mucahit
authors.initials: M
authors.lastname: Emet
authors.affiliation: Department of Emergency Medicine, Antep University Hospital, Gaziantep, Turkey.
authors.forename: Behcet
authors.initials: B
authors.lastname: Al
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010147:Pain Measurement; D012585:Sciatica / Q000188:drug therapy*
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D009020:Morphine