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Pain & sedation
Trauma analgesia safety confirmed across four drug classes
Prehospital Analgesia in Trauma: A Systematic Review of Current Evidence
Emergency Medicine Australasia · 2026-10-28 · Added 29 October 2026
An Israeli-led systematic review of 17 multinational studies (6 RCTs, 17,115 injured adults) found opioids, ketamine, methoxyflurane and paracetamol all effective for prehospital trauma analgesia, with no drug-attributed serious adverse events reported apart from one opioid study.
- Study type
- Systematic review
- Design
- Systematic review of RCTs and observational studies
- Participants
- 17 studies, 17,115 injured adults over 15 years
- Main finding
- All four agent classes (opioids, ketamine, methoxyflurane, paracetamol) showed effectiveness; no drug-attributed serious adverse events except one opioid study, with minor effects like nausea and drowsiness common.
- Caveat
- Only 6 of the 17 included studies were RCTs — most of the evidence is retrospective or observational.
- Bottom line
- Supports current practice
Why it matters in Australia (High relevance). All four agents are standard across Australian ambulance formularies, so the safety findings apply directly to current practice.
Learning goal
Weigh the safety profile of opioid, ketamine, methoxyflurane and paracetamol options when selecting prehospital trauma analgesia.
More
- Topic: Pain & sedation
- Daily scan: 29 October 2026
- Podcast: Paramedic Papers Daily, 29 October 2026
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