Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain

Friedman, Benjamin W.; Dym, Andrew; Davitt, Michelle; Holden, Lynne; Solórzano, Clemencia; Esses, David; Bijur, Polly E.; Gallagher, E. John

doi:10.1001/jama.2015.13043

Cited by 172 publications

(167 citation statements)

References 34 publications

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“…Previous research has shown that functional outcomes are no better for patients with back pain treated with opioids than for those treated with nonsteroidal anti-inflammatory drugs (or other treatment modalities), and current recommendations do not endorse routine prescribing of opioids for this condition. [18][19][20] Independent risk factors that have been associated opioidrelated harms include a history of psychiatric illness or substance use disorder, sleep disorders and the use of nonopioid medications with sedating properties, especially benzodiazepines. [21][22][23] In Research our study, a large number of patients in both the emergency physician and family physician groups had known risk factors associated with adverse outcomes related to opioid use.…”

Section: Discussionmentioning

confidence: 99%

Opioid prescribing and adverse events in opioid-naive patients treated by emergency physicians versus family physicians: a population-based cohort study

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Opioid prescribing and adverse events in opioid-naive patients treated by emergency physicians versus family physicians: a population-based cohort study

et al. 2018

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“…Barksdale et al [10] reported that the nurses of the emergency department were trained in pain classification and applied it to reduce the starting time of pain control for the patients who were visiting because of various pains. In addition, in the study comparing the results of various combinations of painkillers to acute non-traumatic back pain patients, the combination of painkillers and the prognosis of the patient was not related, however, regardless of the degree of pain, the early administration of painkillers helps the patient to control pain quickly, it was reported that even gel-type rubon painkillers were effective [11,12]. In the our study, painkillers were administered to all back pain patients, and the time required to administer the painkillers was significantly shorter in patients in the less than 3 hours group.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Factors Related to Length of Stay Time in Patients with Back Pain at Emergency Department

Choi

Kim

et al. 2017

Journal of Trauma and Injury

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Purpose: Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER. Methods: We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups. Results: A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034). Conclusions: In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.

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“…In acute lower back pain, NSAIDs have been shown to significantly reduce pain and improve daily function [63]. The addition of opioids in this setting of pain was not proven to be more effective than NSAIDs alone [64].…”

Section: Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 99%

“…Moreover, there is little to no added benefit when using muscle relaxants together with NSAIDs [64,67]. Given the limited data on muscle relaxants, one should consider the side effects.…”

Section: Antispasmotics (Muscle Relaxants)mentioning

confidence: 99%

Acute Pain Management in the Emergency Department

Samcam¹,

Papa²

2016

Pain Management

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The most common presenting complaint to the emergency department (emergency room) is pain. Unfortunately, pain is still undertreated in this setting. Literature has shown that treatment of pain not only improves patient satisfaction but also improves mood, decreases length of hospital stay, and decreases mortality. Various pharmacological options are available for treating acute pain, ranging from oral, intravenous, and intramuscular medications; topical agents; and peripheral nerve blocks. Objectively assessing and documenting a patient's pain is the key to determining treatment. The approach to a patient with acute pain requires an experienced clinician who is aware of the pharmacology of analgesics and anesthetics, contraindications, precautions, side effects, administration methods, and monitoring requirements.This chapter briefly covers the pathophysiology of acute pain and the different treatment modalities available to the emergency physician.

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Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain

Abstract: clinicaltrials.gov Identifier: NCT01587274.

Cited by 172 publications

References 34 publications

Opioid prescribing and adverse events in opioid-naive patients treated by emergency physicians versus family physicians: a population-based cohort study

Opioid prescribing and adverse events in opioid-naive patients treated by emergency physicians versus family physicians: a population-based cohort study

Analysis of Factors Related to Length of Stay Time in Patients with Back Pain at Emergency Department

Acute Pain Management in the Emergency Department

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