Chang AK, et al. – In this randomized clinical trial conducted in two emergency departments (EDs) in the Bronx, NY, researchers investigated the efficacy of IV acetaminophen as an analgesic adjunct to IV opioids in the care of older patients with acute severe pain admitted to the ED. They randomized adults aged ≥ 65 years with acute severe pain to 0.5-mg IV hydromorphone and 1-g IV acetaminophen or 0.5-mg IV hydromorphone and 100 cc of normal saline placebo. They did not observe clinically or statistically superior pain relief with the addition of IV acetaminophen to IV hydromorphone as an adjunctive analgesic for acute, severe, pain in this study population vs hydromorphone alone within the first hour of treatment.