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学术急诊医学档案

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  3. 卷 3 编号 3 (2015): Summer (August)
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卷 3 编号 3 (2015)

五月 2015

Comparison of the Analgesic Effect of Intravenous Acetaminophen and Morphine Sulfate in Rib Fracture; a Randomized Clinical Trial

  • Mehrdad Esmailian
  • Roshanak Moshiri
  • Majid Zamani

学术急诊医学档案, 卷 3 编号 3 (2015), 1 五月 2015 , 第 99-102 页
https://doi.org/10.22037/aaem.v3i3.277 已出版: 2018-12-24

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摘要

Introduction: Rib fracture is one of the common causes of trauma disabilities in many events and the outcome of these patients are very extensive from temporary pain management to long-term significant disability. Control and management of the pain in such patients is one of the most important challenges in emergency departments. Thus, the aim of the present study was assessing the efficacy of IV acetaminophen in pain control of patients with rib fracture. Methods: In this double-blind study, 54 patients over 18 years of age, referred to two educational hospitals with rib fracture, were entered. Patients were randomly categorized in two groups of morphine sulfate (0.1 milligram per kilogram of body weight) and IV acetaminophen (1gram), as single-dose infused in 100 cc normal saline. The pain severity was measured by Numeric Rating Scale on arrival and 30 minutes after drug administration. At least three scores reduction was reported as therapeutic success. Results: The mean and standard deviation of patients’ age was 41.2 ± 14.1 years. There is no difference in gender (p=0.24) and age frequency (p=0.77) between groups. 30 minutes after drug administration the mean of pain severity were 5.5 ± 2.3 and 4.9 ± 1.7 in morphine and acetaminophen groups, respectively (p=0.23). Success rate in morphine and acetaminophen groups were 58.6% (95% Cl: 39.6-77.7) and 80% (95% Cl: 63.2-96.7), respectively, (p=0.09). Only 3 (5.6%) patients had dizziness (p=0.44) and other effects were not seen in any of patients. Conclusion: The findings of the present study shows that intravenous acetaminophen and morphine have the same therapeutic value in relieving the pain of rib fracture. The success rate after 30 minutes drug administration were 80% and 58.6% in acetaminophen and morphine groups, respectively. Presentation of side effects was similar in both groups.
关键词:
  • Acetaminophen
  • morphine
  • pain management
  • rib fractures
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Esmailian M, Moshiri R, Zamani M. Comparison of the Analgesic Effect of Intravenous Acetaminophen and Morphine Sulfate in Rib Fracture; a Randomized Clinical Trial. Arch Acad Emerg Med [网际网络]. 2018年12月24日 [见引于 2026年8月18日];3(3):99-102. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/277
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参考

Fabricant L, Ham B, Mullins R, Mayberry J. Prolonged pain and disability are common after rib fractures. Am J Surg. 2013;205(5):511-6.

Brasel KJ, Guse CE, Layde P, Weigelt JA. Rib fractures: Relationship with pneumonia and mortality. Crit Care Med. 2006;34(6):1642-6.

Gordy S, Fabricant L, Ham B, Mullins R, Mayberry J. The contribution of rib fractures to chronic pain and disability. Am J Surg. 2014;207(5):659-63.

Lotfipour S, Kaku SK, Vaca FE, et al. Factors associated with complications in older adults with isolated blunt chest trauma. West J Emerg Med. 2009;10(2):79-84.

Marasco S, Lee G, Summerhayes R, Fitzgerald M, Bailey M. Quality of life after major trauma with multiple rib fractures. Injury. 2014;46(1):61-5.

Paydar S, Farhadi P, Ghaffarpasand F, et al. Acute Trauma Pain Control Algorithm. Bull Emerg Trauma. 2014;2(4):170-1.

Pasero C, Stannard D. The role of intravenous acetaminophen in acute pain management: a case-illustrated review. Pain Manag Nurs. 2012;13(2):107-24.

Yeh YC, Reddy P. Clinical and economic evidence for intravenous acetaminophen. Pharmacotherapy. 2012;32(6): 559-79.

Wattana MK, Nelson LS, Todd KH. Prescription Opioid Guidelines and the Emergency Department. J Pain Palliat Care Pharmacother. 2013;27(2):155-62.

Khan MS, Shuaib W, Evans DD, et al. Evidence-Based Practice: Best Imaging Practice in Musculoskeletal Disorders. J Trauma Nurs. 2014;21(4):170-9.

Farrar JT, Young Jr JP, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149-58.

Todd KH, Funk KG, Funk JP, Bonacci R. Clinical significance of reported changes in pain severity. Ann Emerg Med. 1996;27(4):485-9.

Merritt CK, Salinas OJ, Kaye AD. Pain Control in Acute Trauma. Anesthesia for Trauma: Springer; 2014. p. 107-30.

Karmakar MK, Ho AM-H. Acute pain management of patients with multiple fractured ribs. J Trauma. 2003;54(3): 615-25.

Tsang KS, Page J, Mackenney P. Can intravenous paracetamol reduce opioid use in preoperative hip fracture patients? Orthopedics. 2013;36(2 Suppl):20-4.

Zare MA, Ghalyaie AH, Fathi M, Farsi D, Abbasi S, Hafezimoghadam P. Oral oxycodone plus intravenous acetaminophen versus intravenous morphine sulfate in acute bone fracture pain control: a double-blind placebo-controlled randomized clinical trial. Eur J Orthop Surg Traumatol. 2014;24(7):1305-9.

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