buprenorphine and Abdomen--Acute

Withholding administration of narcotic analgesia in patients with acute abdominal pain for fear of masking pathology is still pervasive in current medical practice. We reviewed all the prospective trials that investigated the safety, adverse affects, and ultimate outcome in patients with acute abdominal pain receiving narcotic analgesia within the emergency department (ED). No adverse outcomes or delays in diagnosis could be attributed to the administration of analgesia. Based on this research, we propose that it is safe and humane to administer narcotic pain relief to patients presenting to the ED with acute abdominal pain provided no contraindications exist.

Topics: Abdomen, Acute; Analgesics, Opioid; Buprenorphine; Diagnostic Errors; Humans; Morphine; Opium; Outcome and Process Assessment, Health Care; Pain Measurement; Prospective Studies; Randomized Controlled Trials as Topic

In a prospective sequential double blind trial 288 patients with acute abdominal pain were given sublingual buprenorphine 200 mcg, sublingual buprenorphine 400 mcg, or placebo. Pain relief was proportional to the number of tablets administered; buprenorphine had no difference in effect compared to placebo. Physical signs altered in proportion to dosage, but this had no effect on clinical diagnosis. We conclude that patients with acute abdominal pain may be given buprenorphine without fear of masking the diagnosis.

Topics: Abdomen, Acute; Adolescent; Adult; Aged; Analgesia; Buprenorphine; Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Humans; Middle Aged; Random Allocation

Topics: Abdomen, Acute; Buprenorphine; Humans