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Randomized clinical trial of IV acetaminophen as an adjunct to IV hydromorphone for acute severe pain in emergency department patients

Academic Emergency Medicine Mar 03, 2020

Bijur PE, Friedman BW, White D, et al. - Since the effectiveness of intravenous (IV) acetaminophen as an adjuvant analgesic in postoperative settings has been shown by the existing evidence, researchers performed this two-arm, double-blind randomized clinical trial to investigate if it also has a role in the Emergency Department. To all patients, 1mg IV hydromorphone was administered. Thereafter, patients were randomly assigned to receive 1g IV acetaminophen or placebo. Using an 11-point numerical rating scale, the between-group difference in alteration in pain from baseline (prior to treatment) to 60 minutes following delivery of study drugs was determined (primary outcome). Findings revealed that neither clinically meaningful nor statistically superior analgesia was provided by 1g of IV acetaminophen added to 1mg of IV hydromorphone vs hydromorphone alone.
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