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

https://doi.org/10.1136/ebm.12.1.23

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    Ranji SR, Goldman LE, Simel DL, et al. Do opiates affect the clinical evaluation of patients with acute abdominal pain? JAMA 2006;296:1764–74.
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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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    Footnotes

    • For correspondence: Dr S Ranji, University of California, San Francisco, CA, USA. sumantr{at}medicine.ucsf.edu

    • Source of funding: no external funding.