Tips from Other Journals

Use of Opiate Analgesics for Acute Abdominal Pain



FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.


FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.

Am Fam Physician. 2000 Nov 1;62(9):2122-2126.

For patients undergoing an evaluation for an acute abdomen, it is typical to withhold opiate analgesic medication until a definitive diagnosis and plan of action has been made. Recently, this longstanding belief has been challenged. Studies suggest that the early administration of pain medication is safe and does not interfere with the ability to make an accurate diagnosis. Wolfe and associates examined the current practice patterns of analgesia administration among emergency department physicians when caring for a patient with an acute abdomen.

The authors prepared a one-page survey of factors that influenced a decision of when and whether to administer pain medication to patients with acute abdominal pain. The survey was mailed to 1,000 members of the American College of Emergency Physicians. The questionnaire was framed in the context of a patient presenting with acute abdominal pain requiring a surgical consultation. Questions in the survey included: “Does conservative use of narcotic pain medication mask important physical examination findings in these patients?”

Forty-four percent (443) of the surveys were completed. Fifty-seven percent of the respondents were residency trained in emergency medicine. The average annual emergency department census was 41,258. Of the physicians who responded, 377 (85 percent) felt that conservative administration of opiate pain medication did not change important clinical findings in patients with acute abdominal pain. However, the same number of respondents chose to administer an opiate analgesic only after surgical evaluation was completed.

In summary, although most providers do not feel that administration of pain medication masks important clinical findings, the majority of physicians wait until after the surgeon has completed the evaluation.

Wolfe JM, et al. Analgesic administration to patients with an acute abdomen: a survey of emergency medicine physicians. Am J Emerg Med. May 2000;18:250–3.


Copyright © 2000 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Article Tools

  • Print page
  • Share this page
  • AFP CME Quiz

Information From Industry

Navigate this Article