Intravenous Acetaminophen Versus Placebo for Severe Pain

In hopes of providing effective pain control while minimizing opioid use, these authors randomized adult emergency department (ED) patients (ages 21–64) with acute, severe pain to receive 1 g of IV acetaminophen or placebo. All patients also received 1 mg of IV hydromorphone. Pain was measured by verbal report using a previously validated pain scale ranging from 0 (“no pain”) to 10 (“worst pain possible”), for which a difference of 1.3 points is considered the minimal clinically significant change. The primary outcome was the difference between the two groups in the change in scores from baseline to 60 minutes.

Of 162 patients enrolled, 159 had data for the primary outcome. Both groups had substantial improvement in mean pain scores at 60 mi…