Table 4
| Author, date, and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study weaknesses |
|---|---|---|---|---|---|
| PRCT = prospective randomised controlled trial. | |||||
| Zoltie and Cust, 1986, UK1 | 288 patients with acute abdominal pain | PRCT | Pain relief | Proportional to dosage | |
| Buprenorphine 200 μg v buprenorphine 400 μg v placebo | Clinical diagnosis | Not affected | |||
| Attard et al, 1992, UK2 | 100 consecutive patients admitted to a surgical firm | PRCT | Pain score | Significantly better with papaveretum (p<0.0001) | Papaveretum no longer used |
| Papaveretum 20 mg v normal saline | Tenderness score | Significantly better with papaveretum (p<0.0001) | |||
| Incorrect diagnosis | 2 after papaveretum v 9 after saline | ||||
| Pace and Burke, 1996, USA3 | 71 adult patients with acute, atraumatic abdominal pain in an emergency department | PRCT | Pain score | Significantly better with morphine (p<0.001) | |
| Accuracy of provisional diagnosis | No difference | ||||
| Morphine IV (35) v normal saline (36) | Accuracy of final diagnosis | No difference | |||
| LoVecchio et al, 1997, USA4 | 48 patients with acute abdominal pain | PRCT | Change in physical examination | Significant changes in both morphine groups | Very small numbers |
| Morphine 10 mg v morphine 5 mg v placebo | Delay in diagnosis | No diagnostic delay in any group | |||
| Vermeulen et al, 1999, Switzerland5 | 340 patients aged 16 years or more with suspected appendicitis | PRCT | Pain relief | Greater in morphine group | |
| Morphine IV (175) v placebo (165) | Sensitivity and specificity of ultrasound diagnoses | No significant difference | |||
| Appropriateness of the decision to operate | No significant difference | ||||
