Objective : To compare intravenous paracetamol to oral paracetamol in the management of patient with moderate
pain in pre hospital setting.
Methods : A prospective, randomized, preliminary study was conducted over 6 months at Emergency Mobile Service.
Adult patients with moderate pain were randomly assigned to receive either the intravenous paracetamol (IV group)
or oral paracetamol (OP group). The primary outcome was Visual Analogue Scale (VAS) pain reduction at 30 min.
A clinically significant change in pain was defined as 15 mm.
Results : Thirty-eight patients were identified, 20 in IV group and 18 in OP group. There was a predominance of
male gender (sex ratio = 1.5), mean age was 33±14 years. No significant difference was demonstrated in this trial
with intravenous paracetamol compared to oral paracetamol in terms of average of pain scale reduction at 30 minute
(17 ± 1 mm in OP group vs 21 ± 13 mm in IV group; p=0.54). However, a significant difference in paracetamolemia
at 30 minute was noted between the two groups (6 ± 5 mg/l in OP group vs 17.5 ± 6 mg/l in IV group; p< 0.001).
Conclusions : Our preliminary study, showed a better bioavailability of the intravenous form of paracetamol.
However there was no significant difference in analgesia.