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Pancreatology. 2013 May-Jun;13(3):201-6. doi: 10.1016/j.pan.2013.02.003. Epub 2013 Feb 26.

Parenteral analgesics for pain relief in acute pancreatitis: a systematic review.

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  • 1Hepatopancreatobiliary Surgery Institute of Gansu Province, The Second General Surgery Department, The First Hospital of Lanzhou University, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, Gansu, China.

Abstract

AIM:

To assess the efficiency and safety of parenteral analgesics for pain relief in acute pancreatitis.

MATERIALS AND METHODS:

We carried out an electronic search of PubMed, Cochrane Library, EMBASE, WEIPU, CNKI and CBM and a manual search for eligible studies. The methodological quality of included trials and quality of evidence were examined by the Cochrane Collaboration's tool for assessing risk of bias and GRADE, respectively. The data were mainly analyzed descriptively and some were pooled by Review manager 5.

RESULTS:

Eight randomized controlled trials with a total of 356 patients were finally included in this systematic review. Compared with procaine, pentazocine led to lower pain severity: day 1, Mean Difference (MD), 95%CI: 40.0 [35.3, 44.7]; day 2, MD, 95%CI: 24.00 [20.88, 27.12]; day 3, MD, 95%CI: 5.00 [2.17, 7.83], and it decreased the requirement for additional analgesics, Relative Risk, 95%CI: 2.23 [1.63, 3.05]. The combination of fentanyl, atropine, droperidol and lidocaine rendered lower pain score: day 1, MD, 95%CI: -5.46 [-6.95, -3.97]; day 2, MD, 95%CI: -5.78 [-7.39, -4.17]. Patients treated with metamizole tended to had lower pain than those treated with morphine, MD, 95%CI: -2.60 [-2.95, -2.25]. Nausea, emesis and vomiting were the common adverse events reported and there was almost no significant difference between different agents on safety.

CONCLUSIONS:

The systemic review showed that the randomized controlled trials comparing different analgesics were of low quality and did not favor clearly any particular analgesic for pain relief in acute pancreatitis.

Copyright © 2013 IAP and EPC. Published by Elsevier B.V. All rights reserved.

PMID:
23719588
[PubMed - indexed for MEDLINE]
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