Abstract
Objective
Previous research demonstrated that administration of Morphine Sulfate Immediate Release
(MSIR) results in similar analgesic efficacy to Oxycodone but with significantly lesser
degrees of euphoria and reward. The purpose of this study sit to investigate if MSIR
combined with Acetaminophen can serve as an opioid analgesic alternative to Oxycodone
combined with acetaminophen (Percocet) for acute pain in the Emergency Department
(ED).
Methods
A prospective, randomized, double-blind trial of ED patients aged 18 to 64 years presenting
with moderate to severe acute pain as defined by an 11-point numeric rating scale
(NRS) with an initial score of ≥5 (0 = no pain and 10 = very severe pain). Patients
were randomized to receive either 15 mg MSIR combined with 650 mg of Acetaminophen
or 10 mg Oxycodone combined with 650 mg Acetaminophen. Patients were assessed at baseline,
30, 45 and 60 min. The primary outcome was reduction in pain at 60 min. Secondary
outcomes include drug likeability and adverse events.
Results
80 patients were enrolled in the study (40 per group). Demographic characteristics
were similar between the groups (P > 0.05). Mean NRS pain scores at baseline were 8.44 for the MSIR group and 8.53 for
the Percocet group (P = 0.788). Mean pain scores decreased over time but remained similar between the groups:
30 min (6.03 vs. 6.43; P = 0.453), 45 min (5.31 vs. 5.48; P = 0.779), and 60 min (4.22 vs. 4.87; P = 0.346). Reduction in mean NRS pain scores were statistically significant from baseline
to 30, 45 and 60 min within each group (P < 0.0001 at each time point for both groups). The largest NRS mean difference was
from baseline to 60 min: 4.2 (95% CI: 3.43 to 5.01) for MSIR group and 3.61 (95% CI:
2.79 to 4.43) for Percocet group. No clinically significant changes or any serious
adverse events were observed in either group.
Conclusion
MSIR provides similar analgesic efficacy as Percocet for short-term pain relief in
the ED, similar rates of nausea/vomiting, and lower rates of likeability of the drug.
Keywords
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Article Info
Publication History
Published online: November 19, 2020
Accepted:
November 15,
2020
Received:
November 3,
2020
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2020 Elsevier Inc. All rights reserved.
