Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2024
Effectiveness and safety of prehospital analgesia with nalbuphine and paracetamol versus morphine by paramedics - an observational study.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Less pain, faster recovery: evaluating 8Fr vs. 22Fr chest tubes in thoracoscopic lung cancer resection.Journal of cardiothoracic surgery · 2026Article
- Inadequate pain management with opioids fentanyl and morphine by paramedics and emergency physicians in rural Germany: an observational study.BMC emergency medicine · 2026Observational
- A Systematic Review of Pain Assessment Tools in Prehospital Emergency Care: Evidence from Observational Studies.Medical journal of the Islamic Republic of Iran · 2026Review
- Prehospital analgesia for trauma-related pain by paramedics: a comparative retrospective observational study of paracetamol, nalbuphine plus paracetamol, and piritramide.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Efficacy and safety of intravenous sufentanil administration in low-severity acute trauma as a competence of paramedics: a follow-up observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Effect of nalbuphine on analgesia and pain factors after gastric cancer resection.World journal of gastrointestinal surgery · 2025Article
- Enhancing prehospital analgesia - advantages and further indications of nalbuphin.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Enhancing prehospital analgesia: addressing methodological concerns and proposing the START-A mnemonic.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the development of various analgesic concepts, prehospital oligoanalgesia remains very common. The present work examines prehospital analgesia by paramedics using morphine vs. nalbuphine + paracetamol.
methodsPatients with out-of-hospital-analgesia performed by paramedics from the emergency medical services of the districts of Fulda (morphine) and Gütersloh (nalbuphine + paracetamol) were evaluated with regards to pain intensity at the beginning and the end of prehospital treatment using the Numeric-Rating-Scale for pain (NRS), sex, age, and complications. The primary endpoint was achievement of adequate analgesia, defined as NRS < 4 at hospital handover, depending on the analgesics administered (nalbuphine + paracetamol vs. morphine). Pain intensity before and after receiving analgesia using the NRS, sex, age and complications were also monitored.
resultsA total of 1,808 patients who received out-of-hospital-analgesia were evaluated (nalbuphine + paracetamol: 1,635 (90.4%), NRS-initial: 8.0 ± 1.4, NRS-at-handover: 3.7 ± 2.0; morphine: 173(9.6%), NRS-initial: 8.5 ± 1.1, NRS-at-handover: 5.1 ± 2.0). Factors influencing the difference in NRS were: initial pain intensity on the NRS (regression coefficient (RK): 0.7276, 95%CI: 0.6602-0.7950, p < 0.001), therapy with morphine vs. nalbuphine + paracetamol (RK: -1.2594, 95%CI: -1.5770 - -0.9418, p < 0.001) and traumatic vs. non-traumatic causes of pain (RK: -0.2952, 95%CI: -0.4879 - -0.1024, p = 0.002). Therapy with morphine (n = 34 (19.6%)) compared to nalbuphine + paracetamol (n = 796 (48.7%)) (odds ratio (OR): 0.274, 95%CI: 0.185-0.405, p < 0.001) and the initial NRS score (OR:0.827, 95%CI: 0.771-0.887, p < 0.001) reduced the odds of having an NRS < 4 at hospital handover. Complications occurred with morphine in n = 10 (5.8%) and with nalbuphine + paracetamol in n = 35 (2.1%) cases. Risk factors for complications were analgesia with morphine (OR: 2.690, 95%CI: 1.287-5.621, p = 0.008), female sex (OR: 2.024, 95%CI: 1.040-3.937, p = 0.0379), as well as age (OR: 1.018, 95%CI: 1.003-1.034, p = 0.02).
conclusionsCompared to morphine, prehospital analgesia with nalbuphine + paracetamol yields favourable effects in terms of analgesic effectiveness and a lower rate of complications and should therefore be considered in future recommendations for prehospital analgesia.
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