Effect of pain control in suspected acute appendicitis on the diagnostic accuracy of surgical residents

CJEM
KyeongWon KangHyun Mi Park

Abstract

To determine the influence of early pain relief for patients with suspected appendicitis on the diagnostic performance of surgical residents. A prospective randomized, double-blind, placebo-controlled trial was conducted for patients with suspected appendicitis. The patients were randomized to receive placebo (normal saline intravenous [IV]) infusions over 5 minutes or the study drug (morphine 5 mg IV). All of the clinical evaluations by surgical residents were performed 30 minutes after administration of the study drug or placebo. After obtaining the clinical probability of appendicitis, as determined by the surgical residents, abdominal computed tomography was performed. The primary objective was to compare the influence of IV morphine on the ability of surgical residents to diagnose appendicitis. A total of 213 patients with suspected appendicitis were enrolled. Of these patients, 107 patients received morphine, and 106 patients received placebo saline. The negative appendectomy percentages in each group were similar (3.8% in the placebo group and 3.2% in the pain control group, p=0.62). The perforation rates in each group were also similar (18.9% in the placebo group and 14.3% in the pain control group, p=0.75). Receiver op...Continue Reading

Citations

Mar 2, 2017·Pediatric Emergency Care·Susan C Lipsett, Richard G Bachur
Dec 3, 2016·CJEM·Andrea L RobbUNKNOWN Pediatric Emergency Research Canada (PERC) Appendicitis Study Group
Feb 4, 2021·Deutsches Ärzteblatt International·Patrick TéouleChristoph Reissfelder

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