Study objective: us evaluate the analgesic and also side effects of including cyclobenzaprine come ibuprofen in emergency department patients with acute myofascial strain. Methods: A randomized, prospective, double-blind research was conducted at an urban teaching ED through an annual census of 44,000. One hundred two patients aged 18 come 70 years with acute myofascial strain resulted in by young trauma in ~ the front 48 hrs were included, and 77 patients completed the protocol. Every patient obtained a solitary dose that 800 mg of ibufrofen in the ED and a vial that 6 capsules comprise 800 mg of ibufrofen to take it every 8 hours as needed after discharge indigenous the ED. In addition, 51 patients received a single dose of 10 mg of cyclobenzaprine and a vial the 6 capsules include 10 mg of cyclobenzaprine to take every 8 hrs as necessary after discharge native the ED; the remaining 51 patients got an identically labeled placebo capsule and also vial that placebo capsules to take every 8 hrs as required after discharge indigenous the ED. Patients rated the intensity of their pain on a 100-mm visual analog scale (VAS) in ~ baseline; 30, 60, 90, 120, and also 180 minutes; and also 24 and also 48 hrs after treatment. Phone call follow-up was acquired at 24 and also 48 hours, and also side impacts were elicited at 24 and also 48 hrs by means of open-ended questioning. Results: The patients in each team were comparable with regard to diagnosis and baseline pain score. The variety of patients that did not complete the protocol and also the number of those who required added analgesia were comparable in both groups. End the 48 hours of the protocol, the mean VAS score because that the combination group lessened from 60.4 come 35.6, and also the average VAS score because that the ibuprofen alone group lessened from 62.2 to 35.4. The mean VAS scores in between groups throughout time was not statistically far-ranging (P =.962, repeated-measures evaluation of variance). In ~ both 24 and 48 hours, central nervous device side impacts were reported more frequently in the patients receiving cyclobenzaprine (16 <42%> matches 7 <18%> at 24 hours and 15 <39%> matches 5 <13%> in ~ 48 hours, respectively). Conclusion: In ED patients v acute myofascial strain, the enhancement of cyclobenzaprine to ibuprofen walk not boost analgesia but is linked with a better prevalence of main nervous device side effects. <Ann Emerg Med.

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☆Supported by the Pittsburgh Emergency Medicine foundation and the Emergency medication Association the Pittsburgh.


The writer report they have no financial attention in the product studied or the agency that to produce it.

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


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