A 9-year-old boy presents with severe right iliac fossa pain. You contact the surgical team who are currently in theatre and will not be able to attend for at least 20 min. You wonder if administering morphine to the boy will hinder or delay diagnosis.

Structured clinical question

In children with acute abdominal pain [patient] does analgesia before surgical consultation [intervention] affect surgical diagnostic accuracy [outcome]?

Search strategy and outcome

Strategy

Medline and Embase were searched using the Dialog Datastar interface.

MEDLINE (1950–date) search terms: (abdominal ADJ pain OR acute ADJ abdomen) AND (analges$ OR pain ADJ relief) AND diagnosis AND LG = EN AND HUMAN = YES AND (CHILD# OR ADOLESCENT.DE. OR INFANT#)

EMBASE (1974–date) search terms: (abdominal ADJ pain OR acute ADJ abdomen) AND (analges$ OR pain ADJ relief) AND diagnosis AND LG = EN AND HUMAN = YES AND CHILD = YES

The BestBETs website was searched.

Outcome

MEDLINE yielded 56 papers and EMBASE yielded 100 papers. BestBETs yielded 1 BET, but although the clinical scenario involved the assessment of a child, all of the evidence related to studies performed in adults.

After …