Ibuprofen Provides Analgesia Equivalent to Acetaminophen–Codeine in the Treatment of Acute Pain in Children with Extremity Injuries: A Randomized Clinical Trial

摘要: Objectives:  This study compared the analgesic effectiveness of acetaminophen–codeine with that ibuprofen for children acute traumatic extremity pain, hypothesis two medications would demonstrate equivalent reduction in pain scores an emergency department (ED) setting. Methods:  was a randomized, double-blinded equivalence trial. Pediatric ED patients 5 to 17 years age received (1 mg/kg as codeine, maximum 60 mg) or (10 mg/kg, 400 mg). The provided Color Analog Scale (CAS) at baseline and 20, 40, 60 minutes after medication administration. primary outcome measured difference changes score 40 minutes, previously described minimal clinically significant change 2 cm. defined (change CAS from baseline) – baseline); negative values thus favor group. Additional outcomes included need rescue adverse effects. Results:  32 34 recipients our convenience sample had indistinguishable baseline. intergroup differences 20 minutes (−0.6, 95% confidence interval [CI] = −1.5 0.3), 40 minutes (−0.4, CI = −1.4 0.6), (0.2, CI = −0.8 1.2) were all less than Adverse effects minimal: vomiting (one patient acetaminophen–codeine), nausea ibuprofen), pruritus acetaminophen–codeine). three each group who radiographically demonstrated fractures dislocations. Conclusions:  found similar performance among aged 5–17 years pain. Both drugs measurable analgesia. Patients tolerated them well, few treatment failures effects.