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Intravenous Acetaminophen vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: A Randomized Clinical Trial.
Adv J Emerg Med 2019; 3(4):e37AJ

Abstract

Introduction

Although pain management in EDs has been fully addressed in clinical trials, prehospital settings have rarely been investigated.

Objective

The present study was conducted to compare the effectiveness of intravenous acetaminophen with that of ketorolac in pre-hospital pain control.

Method

This randomized clinical trial (RCT) was performed at a prehospital setting during EMS missions in Tehran, Iran. The eligible candidates comprised all patients over the age of 7 years with a complaint of moderate to severe pain. The patients were randomly assigned to two groups, one receiving 30 mg of intravenous (IV) ketorolac and the other 1 g of IV acetaminophen. The pain intensity was measured using a visual analog scale (VAS) before administering the analgesic and upon admission to the ED.

Results

The present study was conducted on 150 patients aged 8-81 years with a mean age of 40.4 ± 17.7, including 84 (56%) males. The mean reduction in the pain score was 14.9±8.6 in the acetaminophen group and 16.0±8.8 in the ketorolac group. Univariate analyses suggested no statistically significant differences between the two groups in terms of delta pain score (pain reduction) (P=0.429).

Conclusion

Based on the obtained findings, both ketorolac and acetaminophen could be administered for pain management in prehospital settings in both traumatic and non-traumatic patients in case their contraindications are considered.

Authors+Show Affiliations

Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31633092

Citation

Mahshidfar, Babak, et al. "Intravenous Acetaminophen Vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: a Randomized Clinical Trial." Advanced Journal of Emergency Medicine, vol. 3, no. 4, 2019, pp. e37.
Mahshidfar B, Rezai M, Abbasi S, et al. Intravenous Acetaminophen vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: A Randomized Clinical Trial. Adv J Emerg Med. 2019;3(4):e37.
Mahshidfar, B., Rezai, M., Abbasi, S., Farsi, D., Hafezimoghadam, P., Mofidi, M., ... Khosravi, S. (2019). Intravenous Acetaminophen vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: A Randomized Clinical Trial. Advanced Journal of Emergency Medicine, 3(4), pp. e37. doi:10.22114/ajem.v0i0.130.
Mahshidfar B, et al. Intravenous Acetaminophen Vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: a Randomized Clinical Trial. Adv J Emerg Med. 2019;3(4):e37. PubMed PMID: 31633092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravenous Acetaminophen vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: A Randomized Clinical Trial. AU - Mahshidfar,Babak, AU - Rezai,Mahdi, AU - Abbasi,Saeed, AU - Farsi,Davood, AU - Hafezimoghadam,Peyman, AU - Mofidi,Mani, AU - Almasi,Ramin, AU - Khosravi,Shaqayeq, Y1 - 2019/05/08/ PY - 2019/10/22/entrez PY - 2019/10/22/pubmed PY - 2019/10/22/medline KW - Acetaminophen KW - Emergency Medical Services KW - Ketorolac KW - Pain Management SP - e37 EP - e37 JF - Advanced journal of emergency medicine JO - Adv J Emerg Med VL - 3 IS - 4 N2 - Introduction: Although pain management in EDs has been fully addressed in clinical trials, prehospital settings have rarely been investigated. Objective: The present study was conducted to compare the effectiveness of intravenous acetaminophen with that of ketorolac in pre-hospital pain control. Method: This randomized clinical trial (RCT) was performed at a prehospital setting during EMS missions in Tehran, Iran. The eligible candidates comprised all patients over the age of 7 years with a complaint of moderate to severe pain. The patients were randomly assigned to two groups, one receiving 30 mg of intravenous (IV) ketorolac and the other 1 g of IV acetaminophen. The pain intensity was measured using a visual analog scale (VAS) before administering the analgesic and upon admission to the ED. Results: The present study was conducted on 150 patients aged 8-81 years with a mean age of 40.4 ± 17.7, including 84 (56%) males. The mean reduction in the pain score was 14.9±8.6 in the acetaminophen group and 16.0±8.8 in the ketorolac group. Univariate analyses suggested no statistically significant differences between the two groups in terms of delta pain score (pain reduction) (P=0.429). Conclusion: Based on the obtained findings, both ketorolac and acetaminophen could be administered for pain management in prehospital settings in both traumatic and non-traumatic patients in case their contraindications are considered. SN - 2588-400X UR - https://www.unboundmedicine.com/medline/citation/31633092/Intravenous_Acetaminophen_vs._Ketorolac_in_Terms_of_Pain_Management_in_Prehospital_Emergency_Services:_A_Randomized_Clinical_Trial L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31633092/ DB - PRIME DP - Unbound Medicine ER -