• Xinbo Yin, Xiaokai Wang, and Caiyun He.
• Faculty of Nursing, School of Medicine, Hunan Normal University, Changsha, Hunan, China; Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
• Am J Emerg Med. 2021 Aug 1; 46: 424-429.

ObjectiveMusculoskeletal pain control is essential in the management of trauma patients in the emergency department (ED). Here, we performed a network meta-analysis of the use of analgesics to manage traumatic musculoskeletal pain.MethodThis network meta-analysis (NMA) protocol was registered in PROSPERO (CRD42020150145). Electronic databases were searched for randomized controlled trials comparing systemic pharmaceutical interventions for treating traumatic musculoskeletal pain in the ED setting. The outcomes were global efficacy and changes in pain intensity.ResultsEighteen studies (2656 patients, four medication classes) met the inclusion criteria. The top-ranking medication class for global efficacy was nonsteroidal anti-inflammatory drugs (NSAIDs; network odds ratio: 0.52, 95% credible interval: 0.34-0.81, surface under the cumulative ranking curve score: 86). No interventions were more effective at decreasing pain intensity than opioids at 60 min.ConclusionNSAIDs were the most effective medications for treating traumatic musculoskeletal pain, and combination therapies may not have advantages in the ED setting.Copyright © 2020 Elsevier Inc. All rights reserved.

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