My local EMSA has approved IV Tylenol for pre hospital pain management in trauma patients. Supposedly, studies show that there's little clinical difference in the efficacy of acetaminophen and opioids in acute pain management. I've attempted to find this alleged research, and the link above is what I found. I can't quote it exactly because I'm on mobile and it's being weird, but the relevant section is towards the end and compares the efficacy of IV Tylenol to IV opiates. It leads with saying that the relevant evidence is considered low quality before indicating that (this is a VERY rough summary) IV tylenol seems to have a very similar though slightly less effective/durable analgesic effect. I recommend you read it for yourself. The study also doesn't seem to be limited to trauma patients, and seems to make no distinction between visceral and somatic pain, both things I was hoping to see.

Overall, I can see the benefits: it's cheaper, not addictive, less strictly regulated, doesn't alter consciousness or respiratory drive, and doesn't induce a bunch of histamine to tank a patient's blood pressure. I'm wondering if anyone has any experience with it, and if it works as well as advertised.