What is included in pain management in biliary colic and acute cholecystitis?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Several studies have shown that early pain control in the emergency department in patients with abdominal pain does not hinder the diagnosis. Therefore, administer pain control early, without waiting for the diagnosis or surgical consultation. However, a courtesy call to the surgical consultant before the administration of narcotics offers the expedient opportunity to examine the patients without narcotics, which occasionally diminishes surgical resistance to prediagnosis narcotic use.

Pain control should be achieved with opiate analgesics. [25, 26, 27] In the past, morphine was generally not recommended due to concerns that it may increase the tone of the sphincter of Oddi. This has not been shown to be clinically significant. Anticholinergic antispasmodics, such as dicyclomine (Bentyl), may also be recommended in the initial management of acute biliary colic and cholecystitis for spasm.


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