Evidence map›Paper›PMID 39129925›Full record

ReviewGastro hep advances2022

A Systematic Review and Meta-analysis of Opioids vs Nonopioids in Acute Pancreatitis.

Alfred D Nelson, Nahyr Sofía Lugo-Fagundo, Soumya Jagannath Mahapatra, Wisit Cheungpastiporn, Charat Thongprayoon, Karn Wijarnpreecha, Gaurav Muktesh, Rakesh Kochhar, Pramod Garg, Michael Wallace and 1 more

Abstract readReview
In one paragraph

Review in Gastro hep advances, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Review
  4. Review
  5. Article
  6. Article
  7. Article
  8. How safe are opioids in the early phase of acute pancreatitis?United European gastroenterology journal · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Alfred D NelsonDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Nahyr Sofía Lugo-FagundoDepartment of Internal Medicine, Mayo Clinic, Jacksonville, Florida.
Soumya Jagannath MahapatraDepartment of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Wisit CheungpastipornDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
Charat ThongprayoonDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
Karn WijarnpreechaDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Gaurav MukteshDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Rakesh KochharDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Pramod GargDepartment of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Michael WallaceDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Yan BiDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Although abdominal pain is one of the major criteria to diagnose acute pancreatitis (AP), there are no standardized guidelines to treat this troublesome symptom in the hospital setting. The aims of the study are to conduct a meta-analysis and to assess the efficacy of nonopioids vs opioids for pain management in AP. Methods: We searched the medical literature through May 2021 to identify randomized controlled trials that examined the efficacy of opioids with nonopioids in AP pain management. Efficacy was reported as odds ratio (OR) with 95% confidence intervals (CIs) of each comparison tested. Results: We identified 7 eligible randomized controlled trials, containing 389 patients. No significant difference in terms of pain intensity at day 1 (OR 0.82, 95% CI -2.55 to 4.19) was found between opioids and nonopioids. Nonopioids have a significantly high risk of supplementary analgesic use compared with opioids (OR 3.87, 95% CI 1.25-12.04). However, this significance is not seen when comparing nonsteroidal anti-inflammatory drugs and paracetamol with opioids (OR 1.67, 95% CI 0.73-3.82) after excluding trials with procaine. Opioids did not show a significant increase in the complications of pancreatitis, nausea and vomiting, sedation, and deaths when compared with nonopioids. Conclusion: We found nonopioids, especially nonsteroidal anti-inflammatory drugs and paracetamol, can provide adequate pain relief in patients with AP with no change in supplementary analgesic use and adverse events when compared with opioids. Further research is needed to optimize the use of nonopioids along or in combination with opioids for better pain control in patients with AP.

Indexed as

Acute PancreatitisNonopioidsNSAIDsOpioidsParacetamol

Identifiers

PMID39129925
PMCPMC11308224

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.