UMEM Educational Pearls

Category: Gastrointestional

Title: Biliary Colic and Narcotics

Keywords: HIDA, narcotics, biliary colic (PubMed Search)

Posted: 8/30/2008 by Michael Bond, MD (Updated: 10/23/2020)
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Biliary Colic and Narcotics:

It is common to give patients with biliary colic narcotics inorder to relieve their pain.  It was common teaching in the past that Morphine should be avoided due to the fact that it could cause spasm of the spincter of Oddi.  It is now known that all narcotics, even meperidine, can cause spasm or irritation of the spincter of Oddi.

So this weeks pearls are:

  1. Morphine and diluadid can be used to relieve the pain associated with biliary colic.
  2. However, narcotics should be avoided at least 4 hours prior to a HIDA scan as it can affect the length of the exam and the sensitivity of it.  A HIDA scan can take up to four hours to perform, however, morphine is typically given during the test as it can shorten the exam time to 1.5 hours by increasing filling of the gallbladder through the cystic duct.