The Efficacy of Early Analgesics for Treatment of Acute Abdomen

ABSTRACT

PURPOSE: Discouraging the use of analgesics in patients with acute abdominal pain prior to a definitive diagnosis is a common practice. Recently this viewpoint has been challenged in the field of emergency medicine. We investigated whether early analgesia in an acute abdomen improves the patient's comfort in the emergency department (ED) without any adverse effects. METHODS: From March 2004 to August 2004, we prospectively interviewed 124 patients with acute abdominal pain whose visual analog scale (VAS) was larger than 70. Shock, allergies to analgesics, pregnancy, and a traumatic abdomen were reason for patients being excluded from this study. Among the 124 patients, 57 patients were managed by conventional methods during the first 3 months (group 1), and another 67 patients were administrated analgesics within 10 minutes just after initial physical examination during the second 3 months (group 2). The VAS was used as the baseline to assess abdominal pain before administering analgesics, 30 minutes after administering analgesics, and at the time when the decision was made to admit or discharge the patient. RESULTS: The mean time of analgesics administration after ED visit was 52.2 minutes in group 1 and 10.2 minutes in group 2. The administration rate of analgesics in group 1 was 64.9%, and that of in-patients was 37.5%. The mean VAS score for pain relief was 36.7, and additional analgesics were needed when the VAS was larger than 69.3. At the one week follow up, adverse effects were noted. CONCLUSION: Although the use of early analgesics helped rapid relief of patient's pain, there were no adverse effects in diagnoses or prognoses after early administration of analgesics. Also, an acute abdomen with a VAS larger than 70 called for analgesics to be administerd.