Faculty Collaboration Database

A randomized clinical trial of analgesia in children with acute abdominal pain. Acad Emerg Med 2002 Apr;9(4):281-7

Date

04/03/2002

Pubmed ID

11927450

DOI

10.1111/j.1553-2712.2002.tb01319.x

Scopus ID

2-s2.0-0036211728 (requires institutional sign-in at Scopus site)   119 Citations

Abstract

OBJECTIVE: To evaluate the effects of intravenous morphine on pain reduction, physical examination, and diagnostic accuracy in children with acute abdominal pain.

METHODS: A randomized, double-blind, placebo-controlled clinical trial was conducted at an emergency department of a tertiary care children's hospital. Children aged 5-18 years with abdominal pain of < or =5 days' duration, pain score > or =5 on a 0-10 visual analog scale, and need for surgical evaluation were eligible. Following the initial assessment, patients were randomized to receive either 0.1 mg/kg morphine or an equal volume of saline. The pediatric emergency medicine physician and surgical consultant independently recorded the areas of tenderness to palpation and percussion, and their diagnoses before the study medication and 15 to 30 minutes later.

RESULTS: Sixty patients were enrolled, and 29 received morphine and 31 received saline. The demographic characteristics between the two groups were similar. The median reduction of pain score between the two study groups was 2 (95% CI = 1 to 4; p = 0.002). There was no significant change in the areas of tenderness in both study groups. Children with surgical conditions had persistent tenderness to palpation and/or percussion. There was no significant change in the diagnostic accuracy between the study groups and between the physician groups. All patients requiring laparotomy were identified and no significant complication was noted in the morphine group.

CONCLUSIONS: Intravenous morphine provides significant pain reduction to children with acute abdominal pain without adversely affecting the examination, and morphine does not affect the ability to identify children with surgical conditions.

Author List

Kim MK, Strait RT, Sato TT, Hennes HM

MESH terms used to index this publication - Major topics in bold

Abdomen, Acute
Adolescent
Analgesics, Opioid
Child
Double-Blind Method
Female
Humans
Male
Morphine
Pain Measurement
Physical Examination