Can IV paracetamol be as effective as morphine in pain management?

Intravenous (IV) morphine is frequently used in the emergency department (ED) to control pain in patients with isolated limb trauma. However it can cause several side effects plus, as a controlled drug, it has both storage and administration constraints that may, on occasion, limit its accessibility. On the other hand, IV paracetamol has fewer side effects while still having good analgesic effects thus warranting further investigation around the potential for use of this drug in emergency settings.

A randomised, double-blind, prospective pilot study was undertaken in the ED of Bristol Royal Infirmary. The aim of the study was to compare the clinical effectiveness of IV paracetamol with IV morphine in patients with moderate to severe, traumatic limb pain.

This is the first published study to compare the effectiveness of these drugs in such circumstances. To enable the double-blinding, 60 externally identical phials containing either 1 g IV paracetamol (n=30), or 10 mg IV morphine sulphate (n=30) were randomised at manufacture and consecutively numbered.