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Pain is often undertreated in children with injuries. In a double-blind, randomized clinical trial, investigators compared the efficacy of acetaminophen (15 mg/kg), ibuprofen (10 mg/kg), or codeine (1 mg/kg) in 300 children (age range, 6–17 years) who presented to an Ottawa emergency department with pain from a musculoskeletal injury that had occurred during the previous 48 hours. Pain was assessed on a 100-mm visual analog scale (VAS). Patients with open fractures or intravenous lines in place were excluded.
Sixty minutes after receiving pain medication, children who received ibuprofen reported significantly greater improvement in pain scores than those who received acetaminophen or codeine (mean VAS decrease, 24 mm vs. 12 mm or 11 mm, resp…