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Lookup NU author(s): Dr Manu Nayar, Professor Sanjay PandanaboyanaORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.Background: Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. Objective: This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. Methods: This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1-month follow-up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Results: Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p < 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p < 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre-admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p < 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p = 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre-admission pain duration, acute necrotic collections, and walled-off necrosis also increased the likelihood of opioid prescription at discharge. Conclusion: There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.
Author(s): Knoph CS, Lucocq J, Kamarajah SK, Olesen SS, Jones M, Samanta J, Talukdar R, Capurso G, de-Madaria E, Yadav D, Siriwardena AK, Windsor J, Drewes AM, Nayar M, Pandanaboyana S
Publication type: Article
Publication status: Published
Journal: United European Gastroenterology Journal
Year: 2024
Pages: epub ahead of print
Online publication date: 14/08/2024
Acceptance date: 06/07/2024
Date deposited: 02/09/2024
ISSN (print): 2050-6406
ISSN (electronic): 2050-6414
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1002/ueg2.12641
DOI: 10.1002/ueg2.12641
Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
PubMed id: 39140779
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