The effects of intravenous opioid on abdominal pain and peritoneal irritation in patients presenting to an emergency department
Vahdati, Samad Shams
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Objective: Concerns about possible negative actions of opioids on important diagnostic signs and symptoms have limited the use of this efficient analgesic in patients with abdominal pain. In this study, we have addressed the old challenge with a statistical approach to determine whether this medication can be administered for patients presenting to an emergency department (ED) with signs of non-traumatic acute abdominal condition. Methods and Materials: A randomized clinical trial was arranged with 118 patients who were five years or older who had been prepared for transfer to the operating room in the Hazrat Rasul-e-Akram hospital. In a double blind randomized trial, pain, tenderness and the rebound tenderness ratio were recorded before and after receiving morphine and placebo. Result: Tenderness and the rebound tenderness Numeric Scale Mean dropped after administration of 0.1mg/kg morphine although this was not statistically significant. In contrast to the rebound tenderness (Pv=0.07) the tenderness and pain Numeric Scale Mean fell sharply, showing a statistically significant difference (Pv=0.00, Pv=0.00). However, tenderness and rebound tenderness did not show a significant difference ( Pv=1.00, Pv=0.06). Conclusion: Using morphine does not suppress the main signs of peritoneal irritation, although it provides a suitable control of pain. Therefore, using moprhine as an analgesic in ED cases with a primary impression of a non-traumatic acute abdomen remains advisable with an initial dosage of 0.1mg/kg.