Ibuprofen is recommended as first-line therapy for musculoskeletal pain in children, yet nearly two-thirds report inadequate relief with ibuprofen alone, and the benefit of add-on analgesics remains uncertain. To address this gap, a large study evaluated whether combining ibuprofen with hydromorphone (opioid) or acetaminophen provided superior pain reduction compared with ibuprofen monotherapy in 8,098 children with moderate to severe musculoskeletal pain. The study found that adding hydromorphone or acetaminophen to ibuprofen did not significantly improve pain relief compared with ibuprofen alone in children with musculoskeletal pain, as measured by the verbal Numerical Rating Scale (vNRS).
Mean vNRS scores at 60 minutes were 4.8 in the ibuprofen plus hydromorphone group, 4.6 in the ibuprofen plus acetaminophen group, and 4.6 in the ibuprofen alone group. Adverse events were more…
