<prompt> All are to be done in case of 20 years old female coming to casualty with right iliac fossa pain, with local guarding and tenderness, EXCEPT ?IV glucosePethidine 100 mg. I.M.Nill orallyNone  <response>: Ans is None Answer was Pethidine according to Harrison 14e, p 67, but it has changed in the 15th, 16th and 17th editions. See bel ow? Harrison 14e -- Narcotics or analgesics should be withheld until a definitive diagnosis or a definitive plan has been formulated, because these agents often make it more difficult to secure and to interpret the history and physical finding. Harrison 15e, 16e and 17e -- Narcotics or analgesics should not be withheld until a definitive diagnosis or a definitive plan has been formulated; obfuscation of the diagnosis by adequate analgesia is unlikely. 