articleJAMAJan 8, 2026GREEN OA

Acetaminophen (Paracetamol) or Opioid Analgesia Added to Ibuprofen for Children’s Musculoskeletal Injury

University of Alberta · Women and Children’s Health Research Institute · +20 more institutions

PubMed
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Abstract

Importance

Ibuprofen is first-line therapy for musculoskeletal pain. However, two-thirds of children experience inadequate pain relief with ibuprofen monotherapy, and the efficacy of additive medications for moderate to severe musculoskeletal pain is unclear.

Objective

To determine whether treatment with an opioid (hydromorphone) plus ibuprofen or nonopioid (acetaminophen [paracetamol]) plus ibuprofen decreased pain scores compared with ibuprofen alone. Design, Setting, and Participants: Two randomized, double-masked, placebo-controlled trials were conducted from April 2019 to March 2023 in 6 university-affiliated, tertiary care Canadian pediatric emergency departments. Children aged 6 to 17 years presenting with a nonoperative acute limb injury (

Citation impact

5
total citations
FWCI
115.43
Percentile
100%
References
36
Too recent for citation history.

Authors

38

Topics & keywords

Keywords
  • Ibuprofen
  • Acetaminophen
  • Opioid
  • Musculoskeletal injury
  • Musculoskeletal pain
  • Analgesic
UN Sustainable Development Goals
  • Good health and well-being
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