Hong Kong Journal of Emergency Medicine

Volume 11 Number 2, April 2004

Feasibility study comparing oral paracetamol and oral non-steroidal anti-inflammatory drugs for treating pain after musculoskeletal injury: a randomised, double blind, controlled trial

SY Man, WK Woo, PKW Lam, TH Rainer

Objectives: To investigate the efficacy and safety of oral paracetamol compared with oral non-steroidal anti-inflammatory drugs (NSAIDs) or combination therapy in relieving pain after limb injury in an emergency department. Design: Double blind, randomised, controlled study. Setting: Emergency department of a university hospital in the New Territories of Hong Kong. Subjects: 50 adult patients with painful isolated limb injuries. Main outcome measures: Primary outcome measures were pain relief at rest and with limb movement, and adverse events. Results: There was no statistical difference in the mean reduction in pain score between oral paracetamol and oral NSAIDs in the first two hours of treatment or over three days. Patients' pain reduced significantly over three days but it was unclear whether this was due to natural healing rather than analgesic medication. There was no significant difference in pain relief between paracetamol and NSAIDs over three days treatment. All combinations appeared to be safe with no major adverse effects reported in the study. Conclusion: Oral paracetamol may be as effective and as safe as moderate dose of NSAIDs in the management of musculoskeletal pain. A larger study is required to confirm this hypothesis. (Hong Kong j.emerg.med. 2004;11:78-84)

Keywords : Diclofenac, indomethacin, NSAID, wounds and injuries

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