Graber M A, Ely J W, Clarke S, Kurtz S, Weir R
Department of Family Medicine, College of Medicine, University of Iowa, Iowa City, USA.
Am J Emerg Med. 1999 Mar;17(2):113-6. doi: 10.1016/s0735-6757(99)90039-6.
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. The response rate was 72% (131 of 182). Seven percent of patients with an acute abdomen received pain medications by a general surgeon before being seen and 22% received pain medication by another physician in the emergency department (ED). Fifty-three percent of general surgeons responded that they believe pain medications preclude a patient from signing a valid informed consent; 78% reported that concerns about informed consent enter into their decision to withhold pain medications. Sixty-seven percent agreed that pain medications interfere with diagnostic accuracy, and 82% consider diagnostic accuracy when deciding to withhold pain medication.
为了确定普通外科医生对在急腹症中使用止痛药物的态度，向爱荷华州所有执业普通外科医生邮寄了一份问卷。该问卷旨在确定在获得知情同意之前或对急腹症患者进行检查之前给予止痛药物的频率，以及在不给予止痛药物的情况下，不给予的原因。回复率为72%（182人中的131人）。7%的急腹症患者在被普通外科医生诊治前就接受了止痛药物，22%的患者在急诊科由其他医生给予了止痛药物。53%的普通外科医生表示，他们认为止痛药物会使患者无法签署有效的知情同意书；78%的医生报告说，对知情同意的担忧影响了他们不给予止痛药物的决定。67%的医生同意止痛药物会干扰诊断准确性，82%的医生在决定不给予止痛药物时会考虑诊断准确性。
