Study objective: we evaluate the analgesic and side impacts of adding cyclobenzaprine come ibuprofen in emergency room patients through acute myofascial strain. Methods: A randomized, prospective, double-blind examine was conducted at an metropolitan teaching ED v an annual census of 44,000. One hundred 2 patients age 18 come 70 years through acute myofascial strain brought about by young trauma in ~ the prior 48 hours were included, and also 77 patients completed the protocol. Each patient obtained a single dose the 800 mg of ibuprofen in the ED and also a vial of 6 capsules include 800 mg of ibufrofen to take it every 8 hours as required after discharge native the ED. In addition, 51 patients obtained a solitary dose that 10 mg of cyclobenzaprine and a vial the 6 capsules containing 10 mg of cyclobenzaprine to take every 8 hrs as needed after discharge indigenous the ED; the continuing to be 51 patients obtained an identically labeled placebo capsule and also vial that placebo capsules to take every 8 hours as necessary after discharge indigenous the ED. Patients rated the soot of your pain ~ above a 100-mm visual analog range (VAS) at baseline; 30, 60, 90, 120, and also 180 minutes; and also 24 and 48 hrs after treatment. Phone call follow-up was derived at 24 and also 48 hours, and also side effects were elicited in ~ 24 and also 48 hrs by method of open-ended questioning. Results: The patient in each group were comparable with regard come diagnosis and baseline ache score. The number of patients who did not complete the protocol and also the number of those that required extr analgesia were similar in both groups. Over the 48 hours of the protocol, the typical VAS score because that the mix group diminished from 60.4 come 35.6, and also the typical VAS score for the ibuprofen alone group diminished from 62.2 come 35.4. The mean VAS scores between groups across time was not statistically significant (P =.962, repeated-measures evaluation of variance). At both 24 and 48 hours, main nervous system side impacts were reported more frequently in the patients receiving cyclobenzaprine (16 <42%> matches 7 <18%> at 24 hours and also 15 <39%> matches 5 <13%> in ~ 48 hours, respectively). Conclusion: In ED patients through acute myofascial strain, the addition of cyclobenzaprine to ibuprofen walk not improve analgesia however is associated with a better prevalence of main nervous system side effects. <Ann Emerg Med.

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☆Supported by the Pittsburgh Emergency Medicine structure and the Emergency medicine Association that Pittsburgh.


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


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