Ibuprofen is better at relieving fracture pain in children compared to morphine.

The findings of a randomized trial published Oct. 27 in the Canadian Medical Association Journal show that although both drugs yielded positive results in easing pain linked to these injuries, ibuprofen carries less harmful side effects than morphine.

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Fractures account for a quarter of all injuries in children, and the most severe pain occurs in the first two days after the injury.

There are limited options in providing instant relief for this kind of pain because of safety concerns about some drugs. The evidence for the oral administration of morphine in managing acute pain is insufficient, however.

To address this gap in knowledge and develop a scientific foundation for outpatient analgesic choices in children, researchers from London Health Sciences and Western University in Canada conducted a randomized, superiority trial.

The first group studied consisted of 134 children from ages between 5 to 17 years admitted to the emergency department of Children's Hospital in London and treated using ibuprofen. Researchers compared the results from this group with those from 68 children whose fracture pain was treated with morphine.

There was no significant difference recorded in pain scores between the two drugs. But there were significantly more adverse events recorded among the children in the morphine group, including vomiting, nausea and drowsiness.

The recent findings agree with results from previous studies that studied the efficacy of ibuprofen in treating pain among children with orthopedic injuries. The drug has been proven more effective than either codeine or acetaminophen. Ibuprofen was also linked to less impairment than codeine plus acetaminophen.

Researchers noted that because of the significantly more adverse effects recorded with the use of morphine; ibuprofen is still more effective and safe for outpatient management in treating children's fracture pain.