Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2025
Prehospital analgesia for trauma-related pain by paramedics: a comparative retrospective observational study of paracetamol, nalbuphine plus paracetamol, and piritramide.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- A Systematic Review of Pain Assessment Tools in Prehospital Emergency Care: Evidence from Observational Studies.Medical journal of the Islamic Republic of Iran · 2026Review
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13 authors.
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Abstract
backgroundIn this retrospective observational study, we compared the efficacy and safety of paracetamol compared with those of nalbuphine plus paracetamol and piritramide in prehospital analgesia for trauma-related pain administered by paramedics.
methodsAll prehospital analgesia for trauma-related pain administered by paramedics in the emergency medical services of the districts of Fulda (piritramide) and Guetersloh (paracetamol, nalbuphine plus paracetamol) was analyzed based on electronic medical records. Primary endpoint was effective analgesia defined as a numeric rating scale (NRS) score ≤ 4 at hospital admission. Safety was evaluated based on the occurrence of drug-related complications (nausea/vomiting, antiemetic use, reduced level of consciousness, respiratory or hemodynamic insufficiency).
resultsA total of 1,295 interventions (district of Guetersloh: n = 784 [60.5%], district of Fulda: n = 511 [39.5%]) were analyzed. Paracetamol: n = 291 [22.5%], initial NRS: 6.8 ± 1.4, final NRS: 4.0 ± 1.9. Nalbuphine plus paracetamol: n = 493 [38.1%], initial NRS: 8.2 ± 1.3, final NRS: 3.6 ± 1.9. Piritramide: n = 511 [39.5%], initial NRS: 8.3 ± 1.1, final NRS: 4.3 ± 1.5. The likelihood of achieving NRS ≤ 4 at hospital admission was highest in the nalbuphine plus paracetamol group (odds ratio (OR): 3.25, 95% confidence interval (95% CI): 2.46–4.30) and lower in the piritramide (OR: 0.31, 95% CI: 0.23–0.41) and paracetamol (OR: 0.32, 95% CI: 0.23–0.45) groups. The comparison between piritramide (n = 30 [5.9%]) and nalbuphine plus paracetamol (n = 34 [7.7%]) did not reveal evidence for differences in the occurrence of drug-related complications (OR: 0.75, 95% CI: 0.45–1.24).
conclusionsAnalgesia with nalbuphine plus paracetamol for trauma patients administered by paramedics were more effective in reducing pain to NRS ≤ 4 at hospital admission compared to monotherapy with paracetamol or piritramide, with a comparable safety profile.
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