# Optimising Pain Relief in Acute Pancreatitis: An Evidence-Based Approach

## TL;DR

This paper reviews evidence-based strategies for managing pain in acute pancreatitis, highlighting drugs like NSAIDs and opioids while suggesting future research directions.

## Contribution

The paper proposes a treatment algorithm for pain management in acute pancreatitis, integrating pharmacological and non-pharmacological approaches.

## Key findings

- Non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors show potential in managing pain in acute pancreatitis.
- Current studies are limited by small sample sizes and unidimensional pain assessments.
- Future research should focus on multicenter trials and understanding molecular mechanisms of pain in the condition.

## Abstract

Pain is a dominant symptom in acute pancreatitis, yet high-level evidence guiding optimal analgesic management in acute pancreatitis has been limited. Emerging evidence suggests a role of non-steroidal anti-inflammatory drugs, including cyclooxygenase-2 inhibitors, and opioids in the management of pain in acute pancreatitis patients. Based on a narrative review of the current literature, we provide an overview of available evidence, give an update on recent studies, and propose a treatment algorithm for pain management in acute pancreatitis, considering pharmacological and non-pharmacological modalities, patient comorbidities, and disease severity. Existing studies are generally limited by small sample sizes, heterogeneity in outcomes, unidimensional pain assessments, and a lack of understanding for the pathophysiology of pain in acute pancreatitis. Future trials should focus on multicentre collaboration, comprehensive pain evaluation, adequate sample sizes, and understanding the complex molecular mechanisms of acute pancreatitis pain.