Adequate analgesia for acute pain.

Over one month 103 patients with acute abdominal pain were admitted to the Western Infirmary. Criteria for entry to the study were: (1) no contraindication to the use of potent analgesia or antacid treatment (which might mask important clinical signs); (2) a pain score ¢6 on a visual analogue scalexanging from 0 to 102; and (3) no medical contraindication to the use of potent analgesia. Fifty one patients were included in the study and followed up prospectively during their first 24 hours in hospital.-Provisional diagnosis, time of initial examination, and pain score two hours after the initial examination were recorded. In patients who underwent operation the interval between the decision to operate and the time of operation was also recorded. Four surgical teams managed patients during the study period and were unaware that the study was being conducted. All recordings were made by a single observer and results expressed as mean (SD). The 51 patients (31 women, 20 men; mean age 48 (24-6) years) had a variety of conditions causing their pain (table). Twenty seven (eight treated by operation, 19 treated conservatively; six men, 21 women) received no analgesia in the first 24 hours of their stay in hospital while 24 did (six treated by operation, 18 treated conservatively; 14 men, 10 women). The mean pain scoresofthe two groups were 8-8 (1-2) and 8-1 (1-4) respectively and the meanages 40O7 (22-2) and 55-3 (27-4)