Opioid analgesia and assessment of the sonographic Murphy sign

Nelson, Bret P.; Senecal, Emily L.; Hong, Christine; Ptak, Thomas; Thomas, Stephen

doi:10.1016/j.jemermed.2004.12.009

Cited by 8 publications

(3 citation statements)

References 18 publications

(14 reference statements)

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“…One study 24 (included in our analysis) examined the influence of opiates on the accuracy of ultrasound in diagnosing acute appendicitis; administering opiates increased the specificity of ultrasound, while sensitivity decreased. Another study 39 found no change in the accuracy of the sonographic Murphy sign for diagnosing acute cholecystitis if pa-tients had received opiates. No study has yet investigated the influence of analgesia on the use or interpretation of CT scanning in evaluation of abdominal pain.…”

Section: Scenario Resolutionmentioning

confidence: 98%

Do Opiates Affect the Clinical Evaluation of Patients With Acute Abdominal Pain?

Ranji¹,

Goldman²,

Simel³

et al. 2006

JAMA

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Opiate administration may alter the physical examination findings, but these changes result in no significant increase in management errors. The existing literature does not rule out a small increase in errors, but this error rate reflects a conservative definition in which surgeries labeled as either delayed or unnecessary may have met appropriate standards of care. In published research reports, no patient experienced major morbidity or mortality attributable to opiate administration.

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Section: Scenario Resolutionmentioning

confidence: 98%

Do Opiates Affect the Clinical Evaluation of Patients With Acute Abdominal Pain?

Ranji¹,

Goldman²,

Simel³

et al. 2006

JAMA

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“…In one study, 100% of the radiologists surveyed stated that opioid premedication would negatively impact assessment of the SMS, whereas only 10% of emergency physicians (EPs) surveyed agreed with this statement. However, in a retrospective chart review, the test characteristics of the SMS seemed unaffected by intravenous opioid administration [10]. To date, no study has examined this question in a prospective manner.…”

Section: Introductionmentioning

confidence: 98%

The impact of analgesia on the diagnostic accuracy of the sonographic Murphyʼs sign

Noble

Liteplo²,

Nelson³

et al. 2010

European Journal of Emergency Medicine

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“…For the diagnosis of biliary disease, visualization of gallstones and the presence of an ultrasonic Murphy sign (tenderness on pushing the gallbladder with the ultrasound probe) are simple rapid methods for detecting cholecystitis. When both of these findings are present, positive and negative predictive values for acute cholecystitis are 92% and 95%, respectively, even without further comprehensive assessment of hepatobiliary anatomy (36,37).…”

mentioning

confidence: 99%