PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■尽管腹痛是诊断急性胰腺炎（AP）的主要标准之一，在医院环境中，没有标准化的指南来治疗这种麻烦的症状。该研究的目的是进行荟萃分析，并评估非阿片类药物与阿片类药物在AP疼痛管理中的疗效。
■我们检索了截至2021年5月的医学文献，以确定随机对照试验，这些试验检查了阿片类药物与非阿片类药物在AP疼痛管理中的疗效。功效报告为每个测试比较的比值比(OR)和95%置信区间(CI)。
■我们确定了7项符合条件的随机对照试验，389名患者。阿片类药物和非阿片类药物在第1天的疼痛强度方面没有显着差异（OR0.82，95％CI-2.55至4.19）。与阿片类药物相比，非阿片类药物使用辅助镇痛药的风险明显较高（OR3.87，95％CI1.25-12.04）。然而,在排除使用普鲁卡因的试验后,比较非甾体类抗炎药和扑热息痛与阿片类药物(OR1.67,95%CI0.73~3.82)时,没有发现这一显著性.阿片类药物未显示胰腺炎并发症的显著增加，恶心和呕吐，镇静,与非阿片类药物相比，死亡。
■我们发现了非阿片类药物,尤其是非甾体抗炎药和扑热息痛，与阿片类药物相比，可以为AP患者提供足够的疼痛缓解，而辅助镇痛药的使用和不良事件没有变化。需要进一步的研究来优化非阿片类药物以及阿片类药物的使用或与阿片类药物联合使用，以更好地控制AP患者的疼痛。
■我们检索了截至2021年5月的医学文献，以确定随机对照试验，这些试验检查了阿片类药物与非阿片类药物在AP疼痛管理中的疗效。功效报告为每个测试比较的比值比(OR)和95%置信区间(CI)。
■我们确定了7项符合条件的随机对照试验，389名患者。阿片类药物和非阿片类药物在第1天的疼痛强度方面没有显着差异（OR0.82，95％CI-2.55至4.19）。与阿片类药物相比，非阿片类药物使用辅助镇痛药的风险明显较高（OR3.87，95％CI1.25-12.04）。然而,在排除使用普鲁卡因的试验后,比较非甾体类抗炎药和扑热息痛与阿片类药物(OR1.67,95%CI0.73~3.82)时,没有发现这一显著性.阿片类药物未显示胰腺炎并发症的显著增加，恶心和呕吐，镇静,与非阿片类药物相比，死亡。
■我们发现了非阿片类药物,尤其是非甾体抗炎药和扑热息痛，与阿片类药物相比，可以为AP患者提供足够的疼痛缓解，而辅助镇痛药的使用和不良事件没有变化。需要进一步的研究来优化非阿片类药物以及阿片类药物的使用或与阿片类药物联合使用，以更好地控制AP患者的疼痛。
