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Morphine sulphate analgesia did not affect diagnostic accuracy in undifferentiated abdominal pain

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 QUESTION: In patients with undifferentiated abdominal pain (UAP), does morphine sulphate (MS) analgesia affect physical examination and diagnostic accuracy?

Design

Randomised {allocation concealed}*, blinded {patients, healthcare providers, data collectors, outcome assessors, data analysts}*, controlled trial with intended follow up of 7 days after the study related emergency department (ED) visit.

Setting

A tertiary care centre in Boston, Massachusetts, USA.

Patients

74 patients who were ≥18 years (median age 39 y, 55% women), had severe abdominal pain of <72 hours’ duration, and were being seen in the ED. Patients were excluded if they were pregnant, hypotensive, or allergic to MS; if early opioid analgesia was clearly indicated; or if emergency interventions precluded study enrolment. Follow up was 100%.

Intervention

Patients were allocated to receive MS, 1 mg/ml (n=38), or saline placebo (n=36) for a 60 …

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