Intravenous Acetaminophen and Morphine Versus Intravenous Morphine Alone for Acute Pain in the Emergency Department (ADAMOPA)

  • End date
    Jun 3, 2024
  • participants needed
  • sponsor
    Nantes University Hospital
Updated on 22 April 2022


In emergency medicine, acute pain is a common reason for consultation. It is recommended that patients in moderate to severe pain should receive a combination of intravenous acetaminophen and morphine. However, the data are sparse to support this strategy. Thus, the purpose of our research is to test non-inferiority of IV morphine alone versus IV acetaminophen and morphine in a multicenter, randomized, controlled double blind trial in ED patients with moderate to severe acute pain.


This study is designed to assess whether IV morphine alone is non inferior to combination IV acetaminophen and morphine for the management of moderate to severe pain in the ED. Numeric rating scale pain score will be compared between those who receive morphine alone and who will receive acetaminophen and morphine at 15, 30, 45 and 60 min post first injection.

Condition Pain Management
Treatment placebo of acetaminophen IV, acetaminophen IV
Clinical Study IdentifierNCT04148495
SponsorNantes University Hospital
Last Modified on22 April 2022


Yes No Not Sure

Inclusion Criteria

Years and older
Moderate to severe acute pain, defined as a numeric rating scale score greater than or equal to 5
Conscious patient
Clinical stability at the physician's discretion
Patient able to talk and give a verbal assessment of his/her pain with the numerical verbal scale
Out of guardianship and/or tutorship
Affiliated to the social security plan

Exclusion Criteria

Pregnancy and Breast-feeding
Patient Unable to give numeric rating scale scores
Patient with a weight strictly less than 50kg
acute pulmonary edema, acute respiratory failure
Acute coronary syndrome or unbalanced ischemic heart disease in progress
Acute alcoholic intoxication
Patient who received morphine, or acetaminophen, or analgesic, or anti-inflammatory, for the current acute pain episode, within 8 hours prior to arrival at the emergencies
No possibility of having venous access
History of chronic pain during treatment
Allergy, intolerance or know contraindication to paracetamol or morphine or to an excipient
Renal or hepatic insufficiency
Association with buprenorphine, nalbuphine and pentazocine
Patient unable or unable to give written consent
Clear my responses

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