Does the addition of nonsteroidal anti-inflammatory drugs and codeine to paracetamol (acetaminophen) produce superior analgesia for acute musculoskeletal injuries?

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Why is this study important?

Pain is one of the most common emergency department (ED) presenting complaints, and according to the American Academy of Emergency Medicine, ED clinicians should preferentially utilize non-pharmacological modalities and non-opioid analgesics for analgesia.[1] This study compares the use of nonopioid oral analgesia medication (paracetamol, i.e., acetaminophen and ibuprofen) to opioid containing combination medication (paracetamol and codeine) for the ED treatment of moderate and severe pain due to musculoskeletal injury.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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