Does Giving Early Analgesia Affect the Diagnosis of Acute Appendicitis
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- Category: Vol. 84, December 2016
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Does Giving Early Analgesia Affect the Diagnosis of Acute Appendicitis, SHERIF M. MOKHTAR and MAHMOUD EZZ EL-DEEN
Abstract
Objectives: To determine the effects of NSAIDs on pain intensity, clinical findings, final diagnosis and management of patients with acute abdominal pain.
Methods: This was a randomized clinical trial including 60 patients, with lower abdominal pain lasting for less than 48 hours who were referred to the Emergency Department Kasr Al-Ainy University Hospital between 1/4/2016 and 1/9/2016. Hemodynamically unstable patients were not in-cluded in the study. The baseline pain severity was measured using a Visual Analogue Scale (VAS). Patients were randomly assigned to receive Parenteral NSAIDs ketoprofen (Profenid) 100mg IV) (n=30) or of intravenous normal saline as placebo intravenously (n=30). After 1-hour the patients were then re-examined and the pain severity was re-assessed and the clinical diagnosis was recorded.
Results: There was no significant difference between two study groups regarding the baseline characteristics. The mean pain score on arrival was comparable between groups (6.80± 1.6 vs. 6.81±1.2; p=0.956). The abdominal tenderness was not affected in NSAIDs group. Rebound tenderness disappeared in 4% of the NSAIDs group and in 2% of the placebo group. Nausea was decreased in 14% of the NSAIDs group and 32% of the placebo group. Changes in the clinical pattern and diagnostic peritoneal signs in patients were negligible and did not significantly interfere with the diagnosis (p=0.133). Diagnostic accuracy was 96% in the NSAIDs group and 98% in placebo group, which was not significantly different (p= 0.554).
Conclusion: Administration NSAIDs reduces pain intensity in patients with acute abdominal pain without interference with the clinical diagnosis. Thus analgesics could be safely administered to the patients with acute abdominal pain for increasing the patients comfort.