Using a combination of ibuprofen and acetaminophen in patients presenting at the emergency department with acute pain in their shoulders, arms, hips or legs is as effective at reducing pain than certain opioid and acetaminophen treatment combinations, according to a study published in JAMA.
For the study, researchers enrolled more than 400 patients who presented at two EDs in New York City with acute extremity pain from July 2015 to August 2016. Patients received one of four drug combinations for pain treatment: 400 milligrams of ibuprofen and 1000 milligrams of acetaminophen; 5 milligrams of oxycodone and 325 milligrams of acetaminophen; 5 milligrams of hydrocodone and 300 milligrams of acetaminophen; or 30 milligrams of codeine and 300 milligrams of acetaminophen.
Providers asked patients to rate their pain on an 11-point scale prior to treatment with one of the drug combinations and two hours after treatment. On average, pain scores dropped by 4.3 points for the ibuprofen and acetaminophen group; 4.4 points for the oxycodone and acetaminophen group; 3.5 points in the oxycodone and acetaminophen group; and 3.9 points for the codeine and acetaminophen group.
"For patients presenting to the ED with acute extremity pain, there were no statistically significant or clinically important differences in pain reduction at two hours among single-dose treatment with ibuprofen and acetaminophen or with three different opioid and acetaminophen combination analgesics," concluded the study's authors. "Further research to assess adverse events and other dosing may be warranted."
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