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Analgesia administration for acute abdominal pain in the pediatric emergency department

Ran D Goldman1, Dana Crum, Rudy Bromberg

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics, Population Health Sciences, The Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. ran.goldman@sickkids.ca

Pediatric Emergency Care
|January 19, 2006
PubMed

Insights

Pediatric Emergency Department (PED) physicians administer analgesia more often for children with suspected appendicitis. However, opioid underdosing is common, occurring in 14% of cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Pain Management
  • Clinical Practice Research

Background:

  • Acute abdominal pain is a common pediatric emergency department (PED) presentation.
  • Effective pain management is crucial for pediatric patients experiencing acute abdominal pain.

Purpose of the Study:

  • To document analgesia use in children with acute abdominal pain in a PED.
  • To compare analgesia administration in children with high versus low probability of appendicitis.

Main Methods:

  • Prospective recruitment of 438 patients aged 0-16 years in a Toronto PED.
  • Retrospective chart review for analgesia administration.
  • Physician's appendicitis probability recorded before imaging; final diagnosis verified via follow-up call.

Main Results:

  • 16% of patients had appendicitis; 112 (26%) received analgesia.
  • Analgesia was given more frequently to children with a high probability of appendicitis.
  • Underdosing occurred in 14% of analgesic administrations, particularly with morphine (24%).

Conclusions:

  • Children with suspected appendicitis receive more analgesia, but in only half of cases.
  • Opioid administration is infrequent (15%), and underdosing is a significant issue.
  • Physician suspicion of appendicitis influences analgesia use, not patient age.
Abstract

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