intravenous acetaminophen vs. ketorolac in terms of pain management in prehospital emergency services: a randomized clinical trial

Introduction: although pain management in eds has been fully addressed in clinical trials, prehospital settings have rarely been investigated. objective: the present study was conducted to compare the effectiveness of intravenous acetaminophen with that of ketorolac in pre-hospital pain control. method: this randomized clinical trial (rct) was performed at a prehospital setting during ems missions in tehran, iran. the eligible candidates comprised all patients over the age of 7 years with a complaint of moderate to severe pain. the patients were randomly assigned to two groups, one receiving 30 mg of intravenous (iv) ketorolac and the other 1 g of iv acetaminophen. the pain intensity was measured using a visual analog scale (vas) before administering the analgesic and upon admission to the ed. results: the present study was conducted on 150 patients aged 8-81 years with a mean age of 40.4 ± 17.7, including 84 (56%) males. the mean reduction in the pain score was 14.9±8.6 in the acetaminophen group and 16.0±8.8 in the ketorolac group. univariate analyses suggested no statistically significant differences between the two groups in terms of delta pain score (pain reduction) (p=0.429). conclusion: based on the obtained findings, both ketorolac and acetaminophen could be administered for pain management in prehospital settings in both traumatic and non-traumatic patients in case their contraindications are considered.