November 12, 2014
Notes: Meng, Hongbo
Research Support, Non-U.S. Gov’t
Bosnia and Hercegovina
Bosn J Basic Med Sci. 2013 May;13(2):114-8.
Author Address: Department of General Surgery, Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
Reference Type: Journal Article
Record Number: 5201Author: Meng, W., Yuan, J., Zhang, C., Bai, Z., Zhou, W., Yan, J. and Li, X.
Title: Parenteral analgesics for pain relief in acute pancreatitis: a systematic review
Short Title: Parenteral analgesics for pain relief in acute pancreatitis: a systematic review
Alternate Journal: Pancreatology : official journal of the International Association of Pancreatology
ISSN: 1424-3911 (Electronic)
Accession Number: 23719588
Keywords: Abdominal Pain/*drug therapy
Analgesics/*administration & dosage
Atropine/administration & dosage
Droperidol/administration & dosage
Fentanyl/administration & dosage
Lidocaine/administration & dosage
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.