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We were interested to read the article by Amoli et al1 confirming that morphine reduces pain in patients with acute appendicitis without affecting diagnostic accuracy. Although the trial was said to be carried out according to the Declaration of Helsinki,2 we were concerned that patients in the emergency department with a clinically convincing presentation of acute appendicitis sufficient to warrant booking for appendicectomy were randomised to receive morphine or placebo normal saline.
It may be that …
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