IV Acetaminophen for Acute Pain in Emergency Departments

For adults with moderate to severe pain in the emergency department (ED), IV acetaminophen may offer similar levels of pain relief and a similar risk of adverse events as oral acetaminophen or IV nonsteroidal anti-inflammatory drugs (NSAIDs). For adults with moderate to severe pain in the ED, IV acetaminophen may offer a similar or modestly lower level of pain relief, and a lower risk of adverse events, when compared to IV opioids. We did not find any studies on the cost-effectiveness of IV acetaminophen compared to oral acetaminophen, IV NSAIDs, or IV opioids for treating patients with moderate to severe pain in the ED that met our inclusion criteria. One guideline recommends IV NSAIDs for the initial management of moderate to severe pain for patients in the ED. IV acetaminophen is recommended instead of IV opioids alone.