Safety of early pain relief for acute abdominal pain.

Attard, Alex R.; Corlett, M; Kidner, N. J.; Leslie, Apsara; Fraser, Ian

doi:10.1136/bmj.305.6853.554

Cited by 176 publications

(62 citation statements)

References 5 publications

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“…Administration of opioids does not decrease the diagnostic accuracy of physical examination ((EL A2) [40,41,42,43,44,45,46]), nor does it influence choices made in treatment ((EL A2) [40,42]).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Gans

Pols²,

Stoker³

et al. 2015

Dig Surg

165

117

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Introduction: Diagnostic practice for acute abdominal pain at the Emergency Department varies widely and is mostly based on doctor's preferences. We aimed at developing an evidence-based guideline for the diagnostic pathway of patients with abdominal pain of non-traumatic origin. Methods: All available international literature on patients with acute abdominal pain was identified and graded according to their methodological quality by members of the multidisciplinary steering group. A guideline was synthetized, providing evidence-based recommendations together with considerations based on expertise of group members, patient preferences, costs, availability of facilities, and organizational aspects. Conclusions and Recommendations: Definition: Uniform terminology is needed in patients with acute abdominal pain to avoid difficulty in interpretation and ease comparison of findings between studies. We propose the use of the following definition for acute abdominal pain: pain of nontraumatic origin with a maximum duration of 5 days. Clinical diagnosis: Clinical evaluation is advised to differentiate between urgent and nonurgent causes. The diagnostic accuracy of clinical assessment is insufficient to identify the correct diagnosis but can discriminate between urgent and nonurgent causes. Patients suspected of nonurgent diagnoses can safely be reevaluated the next day. Based on current literature, no conclusions can be drawn on the differences in accuracy between residents and specialists. No conclusions can be drawn on the influence of a gynecological consultation. In patients suspected of an urgent condition, additional imaging is justified. CRP and WBC count alone are insufficient to discriminate urgent from nonurgent diagnoses. Diagnostic imaging: There is no place for conventional radiography in the work-up of patients with acute abdominal pain due to the lack of added value on top of clinical assessment. Computed tomography leads to the highest sensitivity and specificity in patients with acute abdominal pain. Positive predictive value of ultrasound is comparable with CT and therefore preferred as the first imaging modality due to the downsides of computed tomography; negative or inconclusive ultrasound is followed by CT. Based on current literature, no conclusions can be drawn on the added value of a diagnostic laparoscopy in the work-up of patients with acute abdominal pain. Antibiotic treatment should be started within the first hour after recognition of sepsis. Administration of opioids (analgesics) decreases the intensity of the pain and does not affect the accuracy of physical examination.

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Section: Resultsmentioning

confidence: 99%

“…Choice of antibiotics is dependent on local pathogens and national guidelines. Administration of opioids (analgesics) decreases the intensity of the pain and does not affect the accuracy of physical examination (level 1 [40,41,42,43,44]).…”

Section: Resultsmentioning

confidence: 99%

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Gans

Pols²,

Stoker³

et al. 2015

Dig Surg

165

117

View full text Add to dashboard Cite

show abstract

“…3,6,18,22 However, this study showed that the overall clinical impression was similar with or without pain control. The administration of analgesics did not appear to affect the patient's disposition.…”

Section: Discussionmentioning

confidence: 58%

Effect of pain control in suspected acute appendicitis on the diagnostic accuracy of surgical residents

Kang

Kim

et al. 2015

CJEM

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“…49,79,82,83 There is no longer a rationale for withholding analgesics from cats because previously held misconceptions about complications associated with analgesics in the species have been largely discredited. 84,85 But we must remain vigilant for adverse effects in order to manage them correctly.…”

Section: Short Form Of the Glasgow Composite Pain Scalementioning

confidence: 99%

Pain Recognition and Management

Valtolina¹,

Goggs²

2012

Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care

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Accurate recognition and effective management of pain are vital to veterinary critical care. Optimal pain control depends on a sound understanding of the physiology of nociception, an ability to recognize pain behaviors, diligent and thorough pain assessment, and an understanding of the principles of multimodal therapy. We must also be cognizant of potential analgesic-related adverse effects in order to recognize and manage them appropriately.

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Safety of early pain relief for acute abdominal pain.

Abstract: Objectives-(a) to determine the efficacy of papaveretum in treating pain when administered early to patients presenting with acute abdominal pain and (b) to assess its effect on subsequent diagnosis and management.

Cited by 176 publications

References 5 publications

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain

Effect of pain control in suspected acute appendicitis on the diagnostic accuracy of surgical residents

Pain Recognition and Management

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