Safety of early pain relief for acute abdominal pain.
OBJECTIVE
(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.


METHODS
Prospective, randomised, placebo controlled study.


METHODS
Walsgrave Hospital, Coventry.


METHODS
100 consecutive patients with clinically significant abdominal pain who were admitted as emergencies to a surgical firm.


METHODS
Intramuscular injection of up to 20 mg papaveretum or an equivalent volume of saline.


METHODS
Pain and tenderness scores, assessment of patient comfort, accuracy of diagnosis, and management decisions.


RESULTS
Median pain and tenderness scores were lower after papaveretum (pain score 8.3 in control group and 3.1 in treatment group, p < 0.0001; tenderness score 8.1 in control group and 5.1 in treatment group, p < 0.0001). Forty eight patients were deemed to be comfortable after papaveretum compared with nine after saline. Incorrect diagnoses and management decisions applied to two patients after papaveretum compared with nine patients after saline.


CONCLUSIONS
Early administration of opiate analgesia to patients with acute abdominal pain can greatly reduce their pain. This does not interfere with diagnosis, which may even be facilitated despite a reduction in the severity of physical signs. These patients should not be denied effective treatment.
Attard
A R
AR
Department of General Surgery, Walsgrave Hospital, Coventry.
Corlett
M J
MJ
Kidner
N J
NJ
Leslie
A P
AP
Fraser
I A
IA
D015746:Abdominal Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000208:Acute Disease; D003951:Diagnostic Errors; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009892:Opium / Q000627:therapeutic use*; D010147:Pain Measurement; D011446:Prospective Studies; D012449:Safety; D013997:Time Factors
D009892:Opium