Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

作者：Cecilie Siggaard Knoph, James E. Lucocq, Sivesh Kathir Kamarajah, Søren Schou Olesen, Michael Jones, Jayanta Samanta, Rupjyoti Talukdar, Gabriele Capurso, Enrique de‐Madaria, Dhiraj Kumar Yadav, Ajith Kumar Siriwardena, John Albert Windsor, Asbjørn Mohr Drewes, Manu K. Nayar, PAINAP Collaborative, Sanjay Pandanaboyana · 发表于：United European Gastroenterology Journal · 年份：2024 · DOI：10.1002/ueg2.12641 · 被引用次数：17 · 研究领域：Pancreatitis Pathology and Treatment、Pancreatic and Hepatic Oncology Research、Abdominal vascular conditions and treatments

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, ...