• Mohammad Amin Zare, Alireza Hassan Ghalyaie, Marzieh Fathi, Davood Farsi, Saeed Abbasi, and Peyman Hafezimoghadam.
• Emergency Medicine Department, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Niyayesh St, Sattarkhan Ave, 14456, Tehran, Iran.
• Eur J Orthop Surg Tr. 2014 Oct 1;24(7):1305-9.

ObjectivesBone fracture is a common cause of acute pain in emergency and orthopedics departments. Targeting the multifaceted mechanisms of pain with combinations of multiple analgesics (multimodal analgesia) can increase the pain control efforts efficacy and decrease the adverse effects of each medication.MethodsOne hundred and fifty-three patients with acute bone fracture were randomly allocated to two groups receiving intravenous morphine sulfate (74 patients) or oral oxycodone plus intravenous acetaminophen (79 patients). Pain scores and drugs' adverse effects were assessed 10, 30 and 60 min after treatment.ResultsPain scores were similar between groups before, 30 and 60 min after medication but patients in morphine sulfate group experienced less pain 10 min after medication. Eight (10.8%) patients in morphine sulfate group and 26 (32.9%) patients in acetaminophen/oxycodone group experienced nausea that was statistically significant higher (P value = 0.001). Itching was seen in 12 (15.1%) patients of acetaminophen/oxycodone group and three (4.0%) patients of patients in morphine sulfate group (P value = 0.02).ConclusionIntravenous acetaminophen plus oral oxycodone is as effective as intravenous morphine sulfate in acute pain control in emergency department but with a less desirable safety profile.

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