Objective: Abdominal pain is one of the most common complaints in children. The aim of this study was to determine factors associated with administration of opioids to children with abdominal pain who present to the pediatric emergency department (ED). Methods: We retrospectively reviewed all charts of patients with abdominal pain < 7 days presenting to the ED of a tertiary pediatric hospital over a 3 months period. We recorded demographic and illness related variables, and the primary outcome variable was whether opioid analgesia was used to relieve abdominal pain. We analysed the data with a univariate analysis and a multivariate stepwise regression analysis to determine independent influences on the rate of opioid prescribing. Results: Of 582 children included in the analysis, 53 (9%) received opioid analgesia. Pain in the RLQ on exam, documentation of a pain score in triage and the level of acuity as determined by the triage nurse, were predictors of administration of opioids by the physician. 34 (77%) of the opioids given were below the recommended dose for the child.

Conclusion: The decision to use opioid analgesia for acute abdominal pain in the pediatric ED is influenced by acuity level, pain score documentation in triage, and location of abdominal pain. Efforts should be made to educate physicians the appropriate administration and dose of opioids in children with abdominal pain in the ED.