Emergency Management of Acute Abdominal Pain: A Systematic Review

Abstract

Objectives: To examine and summarize the latest research on how acute abdominal pain is managed in emergency care settings. Methods: A detailed computerized search of relevant databases was conducted to identify studies that met the inclusion criteria. The search encompassed PubMed, SCOPUS, Science Direct, Cochrane Library, and Web of Science to find pertinent research. Results: Our analysis included six studies with a total of 1906 patients and females comprised more than half of the participants, totaling 1147 (60.2%). In pediatric emergency care, providing pain relief for acute abdominal pain was both effective and safe, reducing the need for unnecessary surgeries. Using sublingual analgesia proved particularly helpful, as it controlled pain without complicating diagnosis. For adults, intravenous hydromorphone worked better than lidocaine, especially for generalized abdominal pain or kidney stones, though lidocaine often required additional painkillers. Many patients needed surgery, with appendicitis and gallbladder issues being the most common reasons. Patient-controlled analgesia (PCA) led to higher satisfaction compared to morphine, but gender disparities were evident, with women receiving delayed treatment despite reporting similar pain levels as men. Conclusion: This systematic review shows that effective pain management for acute abdominal pain is possible for both pediatric and adult patients in emergency settings. Analgesia in children does not compromise diagnostic accuracy or increase unnecessary surgeries, making it a reliable option. For adults, intravenous hydromorphone is preferred over lidocaine, while patient-controlled analgesia improves satisfaction. Addressing gender disparities in treatment is crucial to ensure all patients receive timely care. Further research is needed to eliminate these biases and enhance the overall standard of care.