Analgesia in patients with acute abdomen: does danger persist?

Abstract

INTRODUCTION: Acute abdominal pain is a very frequent cause of medical consultation. Early analgesia is not usually given to patients that present with it as their chief complaint, because of the many differential diagnoses that must be taken into consideration and also because of fear of the potential complications that may ensue if an early and accurate diagnosis is not made. Nowadays medical practice is evolving and it is pertinent to ask and answer whether it is still adequate to keep these patients without analgesia.

MATERIALS AND METHODS: Medline and Pubmed databases were reviewed in search of studies made on the subject from 1990 to 2005; other references were extracted from the bibliography of such articles.

RESULTS: Twelve relevant articles were found. Although there are great differences among them, none of them proves any causality relationship between giving analgesia and getting any adverse effect. They did prove that patients who received some kind of analgesia experienced significant pain relief.

DISCUSSION: Study design flaws do not allow us to make any strong recommendation on this particular issue. Analgesia is usually considered as a harmless intervention. It is pertinent to perform welldesigned clinical trials that include adequate numbers of patients.