Informed consent and general surgeons' attitudes toward the use of pain medication in the acute abdomen

To determine general surgeons' attitudes about the use of pain medications in the acute abdomen, a questionnaire was mailed to all practicing general surgeons in Iowa. The questionnaire sought to determine the frequency with which pain medications were administered either before informed consent was obtained or before the patient with an acute abdomen was examined, and, in cases when pain medications were withheld, the reasons for withholding. Th e response rate was 72%(131 of 182), Seven percent of patients with an acut e abdomen received pain medications by a general surgeon before being seen and 22% received pain medication by another physician in the emergency depa rtment (ED). Fifty-three percent of general surgeons responded that they be lieve pain medications preclude a patient from signing a valid informed con sent; 78% reported that concerns about informed consent enter into their de cision to withhold pain medications. Sixty-seven percent agreed that pain m edications interfere with diagnostic accuracy, and 82% consider diagnostic accuracy when deciding to withhold pain medication. Copyright (C) 1999 by W .B. Saunders Company.