Analgesics do not interfere with diagnosing abdominal pain

Q&A

J Fam Pract. 2003 June;52(6):431-454

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BACKGROUND: For years physicians have withheld pain medication from patients with abdominal pain to avoid interfering with a surgical evaluation. This recommendation can be traced back to the early 20th century and has, until recently, appeared in Sir Zachary Cope’s textbook on abdominal pain.
POPULATION STUDIED: Eight randomized controlled trials were included in this review, enrolling more than 600 patients. Most were adults with undifferentiated abdominal pain. One study focused on patients between ages 5 and 18 years; one looked only at patients with suspected appendicitis. The settings were emergency rooms or inpatient wards.
STUDY DESIGN AND VALIDITY: The authors performed a MEDLINE search in April 2002 and identified other studies based on subsequent bibliographies. They did not search other databases or attempt to include unpublished trials.
OUTCOMES MEASURED: All studies included pain relief as an endpoint. Most used a 10-cm visual analog pain scale.
RESULTS: In all but 1 study, analgesics were found to produce a statistically significant reduction in pain. No significant side effects, including respiratory depression or cardiovascular compromise, were noted by patients or physicians.

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