Is IV paracetamol as effective an analgesic as IV morphine for patients in non-cardiac pain? A literature review

Abstract

Since the introduction of IV paracetamol to UK ambulance services in 2012 there has been some debate as to which is the better analgesic, IV paracetamol or IV morphine. This literature review was designed to compare the effectiveness of IV paracetamol and IV morphine and consider whether IV paracetamol has any morphine sparing effects. A clinical question was constructed asking: ‘Is IV paracetamol as effective an analgesic as IV morphine for patients in non-cardiac pain?’ and inputted into a variety of journal databases. This returned 2 952 articles, of which 60 abstracts were read and 9 were reviewed, after relevant exclusions were made. It was found that IV paracetamol is as effective as IV morphine and consistently causes fewer adverse reactions, if given as a stand-alone medication. The review suggests that IV paracetamol could significantly reduce the dose of IV morphine required for post-operative patients. The review recommends that paramedics should favour administering IV paracetamol rather than IV morphine, if the clinician is faced with a choice. Current guidelines need to be updated in line with current research that demonstrates the effectiveness and safety of IV paracetamol.