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- W2034286094 abstract "Nissman SA, Kaplan LJ, Mann BD (Albert Einstein Medical Center, Philadelphia, PA) The early administration of narcotic analgesia to patients with acute abdominal pain has not been conventional teaching because it was feared that this practice may alter physical signs and thus make appropriate management difficult. However, many surgical textbooks now advocate the early relief of pain in these patients, whereas other texts hold to the standard teaching that it is inappropriate management to administer early narcotic analgesia to patients with acute abdominal pain. The current clinical practice of emergency departments (EDs) and opinions of physicians regarding early analgesia was assessed. A telephone survey was conducted of emergency physicians at 60 hospitals in the United States to assess current practices and thinking regarding the early administration of narcotic analgesia in the setting of acute abdominal pain before surgical evaluation. In addition, the relevant literature was reviewed for methodologic errors. Of the 60 respondents, 59 (98.3%) reported that their practice is to administer analgesia before surgical evaluation. Of these 59 respondents, only 9 (15.3%) reported that they always informed the surgeon before administering the analgesia to the patient. The 2 most common reasons cited were that patient discomfort takes precedence (88.1%) and that the literature supports the practice as safe (86.4%). This survey found that it is common practice for emergency physicians to administer analgesia to patients with acute abdominal pain before surgical evaluation. However, the literature review found a number of significant design flaws and study limitations in the 4 clinical trials supporting this practice, thus questioning the validity of these studies. As the surgeon is often ultimately responsible for patients presenting with acute abdominal pain, analgesia before diagnosis and surgical evaluation should be administered only with the knowledge and consent of the surgeon who assumes responsibility for decisionmaking." @default.
- W2034286094 created "2016-06-24" @default.
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- W2034286094 date "2004-01-01" @default.
- W2034286094 modified "2023-10-14" @default.
- W2034286094 title "Critically reappraising the literature-driven practice of analgesia administration for acute abdominal pain in the emergency room prior to surgical evaluation" @default.
- W2034286094 doi "https://doi.org/10.1016/j.annemergmed.2003.10.020" @default.
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