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Trauma is a chief cause of pain and suffering. A large number of studies have shown that pain relief provided to patients in the ED is grossly inadequate. Diclofenac, tramadol and ketorolac are the most commonly used intramuscular analgesics and hence selected for this comparative study. The aim of this study was to compare the analgesic duration, efficacy and side effect profile of diclofenac, tramadol and ketorolac administered intramuscularly in patients who presented to the ED with acute trauma pain. Material and methods: In a prospective double-blinded study, 90 patients presenting to the ED with musculoskeletal trauma were randomly selected and divided into 3 groups Group A received 1 ml (50mg) Diclofenac; Group B received 1ml (30mg) Ketorolac; Group C received 1ml (50mg) Tramadol. The efficacy of the drug was measured by observing: pain score, onset & duration of action, rescue drug use, and the patient’s global impression of efficacy of drugs. Collected data was analysed using ANOVA. Results: The time taken to administer the first dose of rescue analgesic was significantly (P <0.05) delayed in the Group B (276mins). Overall, mean scores were significantly better with (Group B) and were not significantly different between other (Group T) and (Group A). Conclusion: Ketorolac was a better analgesic compared to diclofenac and tramadol in managing acute trauma pain.

Management of Acute Trauma Pain in the Emergency Department – A Comparison of Intramuscular Ketorolac, Diclofenac and Tramadol