Study objective: we evaluate the analgesic and also side results of including cyclobenzaprine come ibuprofen in emergency room patients through acute myofascial strain. Methods: A randomized, prospective, double-blind examine was conducted at an city teaching ED through an yearly census of 44,000. One hundred 2 patients age 18 come 70 years with acute myofascial strain brought about by boy trauma within the front 48 hours were included, and 77 patients completed the protocol. Every patient got a single dose of 800 mg of ibuprofen in the ED and also a vial that 6 capsules containing 800 mg of ibufrofen to take it every 8 hours as essential after discharge indigenous the ED. In addition, 51 patients obtained a solitary dose of 10 mg that cyclobenzaprine and a vial of 6 capsules comprise 10 mg the cyclobenzaprine to take every 8 hours as essential after discharge native the ED; the remaining 51 patients obtained an identically labeled placebo capsule and vial the placebo capsules to take it every 8 hrs as needed after discharge indigenous the ED. Patients rated the intensity of their pain ~ above a 100-mm visual analog range (VAS) in ~ baseline; 30, 60, 90, 120, and 180 minutes; and also 24 and 48 hrs after treatment. Phone call follow-up was derived at 24 and also 48 hours, and side effects were elicited at 24 and also 48 hours by method of open-ended questioning. Results: The patient in each group were comparable with regard to diagnosis and also baseline pains score. The variety of patients that did not finish the protocol and the variety of those that required added analgesia were similar in both groups. Over the 48 hours of the protocol, the average VAS score because that the mix group decreased from 60.4 to 35.6, and also the median VAS score because that the ibufrofen alone group diminished from 62.2 to 35.4. The average VAS scores in between groups across time was no statistically significant (P =.962, repeated-measures analysis of variance). In ~ both 24 and also 48 hours, central nervous system side impacts were reported an ext frequently in the patient receiving cyclobenzaprine (16 <42%> versus 7 <18%> in ~ 24 hours and 15 <39%> matches 5 <13%> in ~ 48 hours, respectively). Conclusion: In ED patients with acute myofascial strain, the addition of cyclobenzaprine come ibuprofen go not boost analgesia however is connected with a greater prevalence of main nervous mechanism side effects. <Ann Emerg Med.

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☆Supported by the Pittsburgh Emergency Medicine foundation and the Emergency medicine Association of Pittsburgh.


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Address for reprints: Michael A. Turturro, MD, room of Emergency Medicine, The Mercy Hospital the Pittsburgh, 1400 Locust Street, Pittsburgh, PA 15219; E-mail


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