Ovarian (Adnexal) Torsion Medication

Updated: Sep 29, 2022
  • Author: Erik D Schraga, MD; Chief Editor: Eugene C Lin, MD  more...
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Medication Summary

Pain medication may be given to a patient who presents with abdominal pain that is suspected of deriving from ovarian torsion. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids is acceptable.



Class Summary

Pain control is essential to quality patient care and should not be delayed while the patient is awaiting surgical or gynecologic evaluation.

A review of opioid equivalents and conversions may be found in the following reference article:


Ketorolac (ReadySharp Ketorolac)

Ketorolac inhibits prostaglandin synthesis by decreasing the activity of the enzyme cyclooxygenase, which results in decreased formation of prostaglandin precursors.

Morphine (Astramorph, Duramorph, MS Contin, Avinza, Kadian, Depodur, Infumorph, MorphaBond, Arymo ER)

Morphine is the drug of choice for narcotic analgesia because of its reliable and predictable effects, its safety profile, and the ease with which its effects can be reversed with naloxone.

Morphine sulfate administered intravenously (IV) may be dosed in a number of ways and is commonly titrated until the desired effect is obtained.

For chronic severe pain unremitting to alternative therapy, oral immediate–release and extended-release morphine sulfate may be warranted. Arymo ER is a morphine sulfate abuse-deterrent derivative.



Class Summary

Antiemetics are useful in the treatment of nausea associated with the clinical symptoms of ovarian torsion. Some antiemetics also have sedative effects.

Prochlorperazine (Compazine, Compro)

Prochlorperazine may relieve nausea and vomiting by blocking postsynaptic mesolimbic dopamine receptors through its anticholinergic effects and depressing the reticular activating system. In addition to its antiemetic effects, it has the advantage of augmenting hypoxic ventilatory response, acting as a respiratory stimulant at high altitude.

Metoclopramide (Reglan, Metozolv)

Metoclopramide blocks dopamine receptors in the chemoreceptor trigger zone of the central nervous system.

Ondansetron (Zofran, Zuplenz)

Ondansetron is a selective 5-HT3-receptor antagonist that blocks serotonin both peripherally and centrally. It prevents the nausea and vomiting associated with emetogenic cancer chemotherapy (eg, high-dose cisplatin) and complete-body radiotherapy.