SynthesisWorld journal of surgery2022
Analgesia in the Initial Management of Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Synthesis in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Early Analgesia for the Management of Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Pancreas · 2026Pooled it
- AEG-AESPANC-OPGE-SIED-SPG Ibero-Latin American Guidelines on Acute Pancreatitis (iLATAM-AP).United European gastroenterology journal · 2026Guideline
- European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations.United European gastroenterology journal · 2026Guideline
- Trial
- Review
- Pain characteristics and multimodal analgesia in children hospitalised with pancreatitis: A retrospective study from a tertiary paediatric centre in India.Indian journal of anaesthesia · 2026Article
- Article
- High Serum Lipase Level is Associated With Increased Analgesic Use in Hospitalized Patients With Acute Pancreatitis.Pain research & management · 2026Article
- Morphine use and clinical outcomes in acute pancreatitis: a tertiary-center retrospective cohort study.BMC gastroenterology · 2025Article
- Optimising Pain Relief in Acute Pancreatitis: An Evidence-Based Approach.Journal of clinical medicine · 2025Review
- Management of acute pancreatitis in the "no man's land".Internal and emergency medicine · 2025Review
- Diagnostic and therapeutic management of severe acute pancreatitis. Evidence based medicine (EBM) clinical practice guidelines.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Article
- Diagnosis and Management of Acute Pancreatitis.Diagnostics (Basel, Switzerland) · 2025Review
- Turkish Society of Gastroenterology: Pancreas Working Group, Acute Pancreatitis Committee Consensus Report.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024Review
- Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study.United European gastroenterology journal · 2024Observational
- Guidelines towards comprehensive care in acute pancreatitis.Hepatobiliary surgery and nutrition · 2024Article
- Analgesia for the treatment of acute pancreatitis: a protocol for a systematic review and network meta-analysis.BMJ open · 2024Article
- Neuropancreatology: The Nervous System and Pain Management in Pancreatic Diseases.Life (Basel, Switzerland) · 2024Review
- Acute Pancreatitis Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Current trends in acute pancreatitis: Diagnostic and therapeutic challenges.World journal of gastroenterology · 2023Review
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Authors and funding
13 authors at 9 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal analgesic strategy for patients with acute pancreatitis (AP) remains unknown.
objectiveThe present systematic review and meta-analysis aims to compare the efficacy of different analgesic modalities trialled in AP.
methodsA systematic search of PubMed, MEDLINE, EMBASE, CENTRAL, SCOPUS and Web of Science conducted up until June 2021, identified all randomised control trials (RCTs) comparing analgesic modalities in AP. A pooled analysis was undertaken of the improvement in pain scores as reported on visual analogue scale (VAS) on day 0, day 1 and day 2.
resultsTwelve RCTs were identified including 542 patients. Seven trial drugs were compared: opiates, non-steroidal anti-inflammatories (NSAIDs), metamizole, local anaesthetic, epidural, paracetamol, and placebo. Across all modalities, the pooled VAS scores showed global improvement from baseline to day 2. Epidural analgesia appears to provide the greatest improvement in VAS within the first 24 h but is equivalent to opiates by 48 h. Within 24 h, NSAIDs offered similar pain-relief to opiates, while placebo also showed equivalence to other modalities but then plateaued. Local anaesthetics demonstrated least overall efficacy. VAS scores for opiate and non-opiate analgesics were comparable at baseline and day 1. The identified RCTs demonstrated significant statistical and methodological heterogeneity in pain-relief reporting.
conclusionsThere is remarkable paucity of level 1 evidence to guide pain management in AP with small datasets per study. Epidural administration appears effective within the first 24 h of AP although infrequently used and featured in only a single RCT. NSAIDs are an effective opiate sparing alternative during the first 24 h.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.