ArticleBMC gastroenterology2025
Morphine use and clinical outcomes in acute pancreatitis: a tertiary-center retrospective cohort study.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis 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.
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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.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Perioperative nursing management in video-assisted retroperitoneal debridement for severe acute pancreatitis with infected peripancreatic necrosis: a retrospective single-center case series of 41 patients.Frontiers in surgery · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe safety of morphine in acute pancreatitis (AP) remains controversial due to theoretical risks of exacerbating complications. This study evaluated whether early morphine use correlates with clinical deterioration in AP.
methodsIn this retrospective cohort study, 154 patients with AP (diagnosed per Revised Atlanta Criteria) treated at a tertiary center (2012-2024) were stratified by morphine use within 48 h of admission. The primary outcome was a composite of clinical deterioration (30-day mortality, mechanical ventilation, vasopressor use, surgery, prolonged hospitalization, CRP doubling, or new organ failure). Associations were assessed using multivariable logistic regression adjusted for age, sex, admission severity, and inflammatory markers.
resultsOf 154 patients, 53 received early morphine. Baseline age and sex distributions were similar between groups, but morphine recipients had lower mechanical ventilation rates (17.0% vs. 35.6%, p = 0.02) and higher hemoglobin (131.0 vs. 122.0 g/L, p = 0.01). Clinical deterioration occurred in 49.1% (morphine) vs. 62.4% (non-morphine), with no significant difference (adjusted OR = 0.61, 95% CI: 0.29-1.28, p = 0.19). High-dose opioids (MME ≥ 100, n = 24) showed no association with deterioration (adjusted OR = 0.92, 95% CI: 0.33-2.54, p = 0.87). Severity-adjusted analyses confirmed these findings.
conclusionsIn this cohort, early morphine and opioid use were not associated with clinical deterioration in acute pancreatitis. These findings support the safety of early opioid analgesia for pain control in AP, although residual confounding cannot be excluded. Prospective studies are needed to confirm causality and inform guideline recommendations.
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