• Eur J Emerg Med · Dec 2007

    Analgesic efficacy of orodispersible paracetamol in patients admitted to the emergency department with an osteoarticular injury.

    • Alain Viallon, Olivier Marjollet, Pantéa Guyomarch, Florianne Robert, Cristophe Berger, Stéphane Guyomarch, Marie Louise Navez, and Jean-Claude Bertrand.
    • Emergency and Intensive Care Units, Bellevue Hospital, Saint-Etienne, France. alain.viallon@univ-st-etienne.fr
    • Eur J Emerg Med. 2007 Dec 1;14(6):337-42.

    IntroductionAcute pain still persists in patients under treatment after admission to emergency departments (ED). The objective of this study was to determine the efficacy of 1 g of paracetamol in patients presenting an osteoarticular injury.Materials And MethodsThis prospective study included all patients admitted to the ED with an osteoarticular injury and a pain score above 30 on the visual analogue scale (VAS). Patients were selected on admission by the reception nurse and given paracetamol within 5 min of admission. VAS scores were recorded 30 and 60 min after admission. On discharge from the ED, the patients underwent a further VAS assessment and were asked a question about pain relief (yes/no answer). The primary endpoint was the VAS score at 60 min. The secondary endpoint was the pain relief expressed by the patient on discharge from the ED.ResultsFive hundred and seventy-one patients were included. The median stay in the ED was 90 min (75-120 min). The diagnoses at discharge were sprain or dislocation (ankle, knee, and wrist) for 287 patients, fracture for 102 patients, and other injury for 182 patients. In 69% of the patients, the injured limb was immobilized. The median VAS score on admission was 57. A significant difference was seen between the median VAS on admission and at 1 h after admission (57+/-18 vs. 30+/-18; P<0.0001), and between the median VAS score at admission and the score at discharge from the ED (57+/-18 vs. 26+/-18, P<0.0001). Finally, 81% of the patients expressed pain relief. On discharge from the ED, a gain of 20 mm on the VAS had a positive predictive value of 93% [area under curve (AUC): 89; CI: 86-92; P=0.001], for the endpoint 'patients stating pain relief'.ConclusionA simple and easily applicable protocol of pain management permits the achievement of satisfactory analgesia during a patient's stay in the ED.

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