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Review: opiate administration may alter physical examination findings but does not increase management errors in acute abdominal pain

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 Q In patients with acute abdominal pain, does opiate administration for pain relief alter history and physical examination findings and increase management errors?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Gastroenterology ★★★★★★☆ Surgery—general ★★★★★★☆ Surgery—gastrointestinal ★★★★★★☆ Emergency medicine ★★★★★☆☆

METHODS

Embedded ImageData sources:

Medline (to May 2006), EMBASE/Excerpta Medica, and bibliographies of relevant studies.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) or quasi-randomised controlled trials that compared opiate analgesia with placebo and reported changes in history, physical examination findings or clinical management in patients with acute abdominal pain. 12 RCTs, 9 in adults (n = 1062) and 3 in children (n = 291), met the selection criteria. Quality …

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