Health Questions and Answers

QUESTION: Is there a place for narcotic analgesics in the management of acute abdominal pain of uncertain cause?

ANSWER:

For fear of masking vital symptoms or physical findings, conventional surgical wisdom proscribes the use of narcotic analgesics until a firm diagnosis is established. More recently, some experts have suggested that pain medication may be given to selected patients with stable vital signs because the analgesic effect may be reversed readily at any time after the administration of naloxone.
Pace and Burke, in a prospective, double-blind study of 71 patients with acute abdominal pain, found that pain control with morphine (versus normal saline) had no deleterious effect on preoperative diagnostic accuracy. Although inconclusive, a growing body of data suggests that evaluation of acute abdominal disease may be facilitated when severe pain has been controlled and the patient can cooperate more fully. Surgical consultation should be obtained and all appropriate consent forms for anticipated treatment completed in patients needing surgery before the administration of large doses of narcotics. Patients who have received narcotics for pain control should be discouraged from leaving the Emergency Room (ER) against medical advice.

2 Responses to “QUESTION: Is there a place for narcotic analgesics in the management of acute abdominal pain of uncertain cause?”

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