Table 3.
Details of trial criteria and process.
| Study | Sample size | Time of pain to admission | Inclusion and exclusion criteria | Intervention group | Control group | Observation time | Pain assessment (tool and frequency) | Rescue analgesia | Outcome measures |
|---|---|---|---|---|---|---|---|---|---|
| Blamey et al. (33) | 32 | NR | NR | Pethidine (100 mg, i.m.) | Buprenorphine (0.3 mg, i.m.) | 24 h | VAS (0–10); baseline and 24 h after treatment | Pethidine (100 mg, i.m.) | VAS (0–10) |
| Ebbehoj et al. (34) | 30 | NR | NR | Indomethacin (50 mg, rectal, twice/day) | Placebo | 168 h | VAS (0–10); daily | Opiates | VAS (0–10); pain free days; number of rescue analgesic injections during 7 days treatment |
| Jakobs et al. (39) | 40 | NR |
Included: Not specified; Excluded: Cardiac arrhythmias or previous severe arrhythmias, pregnancy, contradictions to anaesthetics |
Procaine (2 g/day, i.v.) | Buprenorphine (0.3 mg bolus maintained with 2.4 mg per day, i.v.) | 72 h | VAS (0–100); 3 times a day | Opiates | VAS (0–100); need for rescue analgesia |
| Stevens et al. (44) | 32 | NR |
Included: Pain ≥ 2 on verbal self-report scale (0–5); Excluded: Respiratory diseases, contradictions to anaesthetics |
Fentanyl (50 mg/h, TTS for 3 days) | Placebo | 72 h or discharged earlier | McGill-Melzack Pain Q and verbal self-report scale (0–5); every 3 h | Demerol (50–100 mg, every 3 h as needed for 3 days) | Verbal self-report scale (0–5); total amount of fentanyl and Demerol |
| Kahl et al. (40) | 101 | <72 h |
Included: Not specified; Excluded: Any analgesic prior to hospitalisation and pregnancy |
Pentazocine (30 mg/kg, i.v., every 6 h) | Procaine (2 g/24 h, continuous i.v.) | 96 h | VAS (0–100); baseline, and twice daily | Pentazocine | VAS (0–100); total amount of pentazocine |
| Peiró et al. (43) | 16 | <12 h |
Included: Not specified; Excluded: Advanced comorbidities, contradictions to anaesthetics |
Morphine (1%, 10 mg/4 h, s.c.) | Metamizole (2 g/8 h, i.v. for 3 min) | 48 h | VAS (0–100); baseline and every 4 h | Pethidine | Pain free within 24 h (<15 mm VAS) |
| Layer et al. (36) | 44 | NR |
Included: Not specified; Excluded: Advanced comorbidities, pregnancy, contradictions to anaesthetics |
Procaine (2 g/24 h, i.v.) | Placebo | 72 h or until pain free | VAS (0–100); daily and after analgesic given | Metamizole or buprenorphine | Final change of pain intensity (delta VAS 72 h); need for rescue analgesia; response rate |
| Sadowski et al. (37) | 35 | NR |
Included: Ranson ≥ 2 and/or CRP > 100 mg/l and/or necrotising AP; Excluded: Contradictions to anaesthetics |
Bupivacaine (0.1%, PCEA) + Fentanyl (2 μg/ml, PCEA) | Fentanyl (10 μg/ml, PCIA) | 72–120 h | VAS (0–10); every 8 h | Fentanyl PCIA | VAS (0–10); pancreatic blood perfusion |
| Gülen et al. (38) | 90 | <24 h |
Included: VAS > 40/100 mm Excluded: Taken NSAID <24 h, advanced comorbidities, trauma, contradictions to anaesthetics |
Tramadol (1 mg/kg in 100 ml saline, i.v., for 4–5 min) | Paracetamol (1,000 mg, i.v., for 4–5 min) or dexketoprofen (50 mg/kg, i.v., for 4–5 min) | 0.5 h | VAS (0–100); baseline and 30 min after drug given | Morphine | Pain relief at 30 min; need for rescue analgesia |
| Mahapatra et al. (42) | 50 | <7 days |
Included: Organ failure grade <2; Excluded: Comorbid coronary artery disease, altered sensorium, serum creatinine ≥ 1.5 mg/dl, paralytic ileus, chronic pancreatitis |
Pentazocine (30 mg, Q8h, i.v., for 24 h) | Diclofenac (75 mg, Q8h, i.v., for 24 h) | 40 h | NR | Fentanyl PCIA | Dose of rescue analgesic; pain free period; total number of demands of the rescue analgesic |
| Huang et al. (35) | 188 | <48 h |
Included: APACHE II ≥ 8; Excluded: AP due to trauma; drug allergy |
Conventional treatment | Parecoxib (40 mg per day, p.o., for 3 days) and celecoxib (200 mg, twice daily, p.o., for 7 days) | 72 h | VAS (0–10); baseline and every 4 h during the first 3 days | (50–100 mg, i.m.) | VAS (0–10) |
| Kumar et al. (41) | 41 | <72 h |
Included: Not specified; Excluded: Advanced comorbidities, pregnancy, contradictions to anaesthetics, lack of informed consent |
Diclofenac (1 mg/kg, i.v., over 5 min twice daily) | Tramadol (1 mg/kg, i.v., over 5 min twice daily) | 168 h | VAS (0–100); assessed 1, 3, 6, 12 and 24 h after drug given, then every 6 h | Morphine (0.06 mg/kg) after the first 1 h then (0.03 mg/kg) after another 30 min | VAS after 1 h of drug administration and need for rescue analgesia |
NR, not reported; i.m., intramuscular; VAS, visual analogue scale; i.v., intravenous; TTS, transdermal therapeutic system; CRP, C-reactive protein; AP, acute pancreatitis; PCEA, patient-controlled epidural anaesthesia; PCIA, patient-controlled intravenous analgesia; NSAID, non-steroidal anti-inflammatory drug; APACHE II, Acute Physiology, Age and Chronic Health Evaluation II.