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Effect on diagnostic efficiency of analgesia for undifferentiated abdominal pain. BJS 2003; 90: 5-9.

Published: 29th November 2002

Authors: S. H. Thomas, W. Silen


The question of whether it is safe to provide analgesia for patients with undifferentiated acute abdominal pain is marked by longstanding controversy over the possible masking of physical findings. The goal of this review is to assess the pertinent studies.


A total of eight trials (one reported only as an abstract) were identified. Because of significant disparity in trial design, no formal analysis such as meta‐analysis was performed. However, detailed review of the trials revealed a striking consistency in results. In no study was there an association between analgesia and diagnostic impairment or dangerous masking of the findings of physical examination.


The literature addressing early pain relief for abdominal pain is characterized by weaknesses, but there is a common theme suggesting that analgesia is safe. Pending further research, which should address some of the shortcomings of extant studies, a practice of judicious provision of analgesia appears safe, reasonable and in the best interests of patients in pain. Copyright © 2002 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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