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How Safe Are Opiates for Patients With Acute Abdominal Pain?

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How Safe Are Opiates for Patients With Acute Abdominal Pain?
Ranji SR, Goldman LE, Simel DL, Shojania KG
JAMA. 2006;296:1764-1774

Is it safe to give opiate analgesics to patients with acute abdominal pain? The authors attempted to answer this question by reviewing 492 publications, from which they selected 11 reports on placebo-controlled trials. Eight of these trials were conducted in adult populations and 3 in pediatric patients. The trials indicated that although opiate administration may diminish the perception of abdominal pain, it did not appear to increase management errors, such as delay in surgery or misdiagnosis. The authors conclude that giving opiates to patients with abdominal pain does not result in any major harm.

Surgeons traditionally have been reluctant to administer opiates to patients with abdominal pain because it may reduce the patient's pain perception and so alter the physical findings and lead to a delay in diagnosis. This report does not include any information about the frequency of perforation, presence or absence of wound infection, or length of stay. Such information would have strengthened the findings. However, it does seem reasonable to administer opiates to patients with abdominal pain after arriving at a decision to operate.

Abstract

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