Re-Reading the Paracetamol V/S Morphine Study...Morphine is still better

• In January 12 post...The results of Randomised comparison IV paracetamol to Morphine showed that 1 g IV morphine is comparable to IV 10 mg of Morphine...But after re-reading the results you will discover that Morphine still the better option for acute pain management.

Why the results of this study cannot be the trigger to shift into paracetamol instead of Morphine..

• n = 55 so tiny numbers which is the single biggest problem
• paracetamol group had consistently higher pain (about 6mm) but it decreased in the same manner as the morophine group and they were of comparable efficacy
• neither group did that well (pain went from 75 to 55 over an hr) and 1/3 in each group wanted resuce meds
• they state a statistically significant increase in AEs in the morphine group but this was 8 vs 2 pts and they don’t tell us specifically what those AEs were
• more pts were satisfied in the morphine group.

They conclude that a large trial is needed to answer this, and it seems that it probably does. This one is two small to change practice over. Especially when it involves something almost 10 times the price.

SO till now Morphine still better

check  january 12 post
http://anesthesia-resident.blogspot.com/2012/01/paracetamol-comparable-to-morphine.html