Campillo Arregui Ana, Bolado Concejo Federico, León Brito Helena, Martínez-Acítores de la Mata Diego, Ubieto Capela Verónica, Cebrián García Alba, Kutz Leoz Marcos, Laiglesia Izquierdo Matilde
Unidad de Aparato Digestivo, Hospital Reina Sofía, Tudela de Navarra, España.
Servicio de Aparato Digestivo, Hospital Universitario de Navarra, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España.
Gastroenterol Hepatol. 2024 Mar;47(3):230-235. doi: 10.1016/j.gastrohep.2023.05.006. Epub 2023 May 18.
Acute pancreatitis is one of the main reasons for digestive admissions. Adequate pain treatment is crucial in its management. However, there are hardly any descriptions of the analgesic guidelines used in our setting.
On-line survey on analgesic management in acute pancreatitis, aimed at attending physicians and residents practising in Spain.
Two hundred and nine physicians from 88 centres responded to the survey. Ninety percent were specialists in gastrointestinal medicine and 69% worked in a tertiary centre. The majority (64.4%) do not routinely use scales to measure pain. When choosing a drug, experience in its use was the most important factor. The most commonly prescribed initial treatments are: combination of paracetamol and metamizole (53.5%), paracetamol alone (19.1%) and metamizole alone (17.4%). As rescue: meperidine (54.8%), tramadol (17.8%), morphine chloride (17.8%) and metamizole (11.5%). Continuous perfusion is used in 8.2% of initial treatments. Physicians with >10 years of service use more metamizole as monotherapy (50%), while residents and attending physicians with <10 years of service prescribe it in combination with paracetamol (85%). If progression is needed, morphine chloride and meperidine are mainly used. The speciality of the respondent, the size of the work centre and the unit/service where the patients were admitted did not influence the analgesia prescribed. Satisfaction with pain management reached 7.8/10 (SD 0.98).
In our setting, metamizole and paracetamol are the most commonly used analgesics as initial pain treatment in acute pancreatitis, and meperidine is the most commonly used rescue analgesic.
急性胰腺炎是消化系统住院的主要原因之一。充分的疼痛治疗在其管理中至关重要。然而，在我们的环境中几乎没有关于所使用的镇痛指南的描述。
针对在西班牙执业的主治医师和住院医师进行急性胰腺炎镇痛管理的在线调查。
来自88个中心的209名医生回复了调查。90%是胃肠病学专家，69%在三级中心工作。大多数（64.4%）不常规使用疼痛量表来测量疼痛。在选择药物时，用药经验是最重要的因素。最常用的初始治疗药物是：对乙酰氨基酚和安乃近联合使用（53.5%）、单独使用对乙酰氨基酚（19.1%）和单独使用安乃近（17.4%）。作为解救药物：哌替啶（54.8%）、曲马多（17.8%）、吗啡（17.8%）和安乃近（11.5%）。8.2%的初始治疗采用持续灌注。工作年限超过10年的医生更多地将安乃近作为单一疗法使用（50%），而工作年限不足10年的住院医师和主治医师则将其与对乙酰氨基酚联合使用（85%）。如果需要进一步治疗，主要使用吗啡和哌替啶。受访者的专业、工作中心的规模以及患者入院的科室/服务部门对所开的镇痛药物没有影响。对疼痛管理的满意度达到7.8/10（标准差0.98）。
在我们的环境中，安乃近和对乙酰氨基酚是急性胰腺炎初始疼痛治疗中最常用的镇痛药，哌替啶是最常用的解救镇痛药。
