Stead Family Department of Pediatrics, The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA.
The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA.
BMJ Open. 2024 May 13;14(5):e081971. doi: 10.1136/bmjopen-2023-081971.
Gastrointestinal hospitalisations in the USA cause over US$130 billion in expenditures, and acute pancreatitis is a leading cause of these hospitalisations. Adequate pain control is one of the primary treatment goals for acute pancreatitis. Though opioids are commonly used for analgesia in these patients, there have been concerns about short-term and long-term side effects of using opioids. Recently, non-opioid medications have been studied to treat pain in patients with acute pancreatitis. This systematic review and network meta-analysis aims to assess the comparative efficacy of analgesic medication for non-severe, acute pancreatitis.
We will search multiple electronic databases for randomised controlled trials that study pain management in patients with non-severe, acute pancreatitis. The intervention will be any analgesic for acute pancreatitis in the hospital setting. The comparison group will be patients who received a placebo or other active interventions for pain management. The primary outcomes of interest include pain scores and the need for supplementary analgesia. The secondary outcomes will be serious adverse events, local complications, progression to severe pancreatitis, transfer to the intensive care unit, length of hospitalisation, time to start enteral feeds, 30-day all-cause mortality and Quality of Life Scale scores. If sufficient homogeneity exists among included studies, the findings will be pooled using a traditional pairwise and network meta-analysis. The risk of bias in randomised control trials will be evaluated using the Cochrane Risk of Bias Tool 2.0. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to report the certainty of evidence.
This systematic review will not involve direct contact with human subjects. The findings of this review will be published in a peer-reviewed journal. They will give healthcare providers a better awareness of the optimal analgesic medication for pain treatment in non-severe, acute pancreatitis.
美国因胃肠病住院治疗的费用超过 1300 亿美元，急性胰腺炎是导致这些住院的主要原因之一。充分的疼痛控制是急性胰腺炎的主要治疗目标之一。尽管阿片类药物常用于这些患者的镇痛，但人们一直担心使用阿片类药物的短期和长期副作用。最近，已经研究了非阿片类药物来治疗急性胰腺炎患者的疼痛。本系统评价和网络荟萃分析旨在评估非重症急性胰腺炎的镇痛药物的比较疗效。
我们将在多个电子数据库中搜索研究非重症急性胰腺炎患者疼痛管理的随机对照试验。干预措施将是医院环境中用于治疗急性胰腺炎的任何镇痛药。对照组将是接受安慰剂或其他用于疼痛管理的活性干预的患者。主要观察指标包括疼痛评分和辅助镇痛的需求。次要观察指标包括严重不良事件、局部并发症、进展为重症胰腺炎、转入重症监护病房、住院时间、开始肠内喂养的时间、30 天全因死亡率和生活质量量表评分。如果纳入研究之间存在足够的同质性，将使用传统的两两和网络荟萃分析对研究结果进行汇总。将使用 Cochrane 风险偏倚工具 2.0 评估随机对照试验的偏倚风险。将使用推荐、评估、制定和评估方法对证据的确定性进行报告。
本系统评价不会涉及与人类受试者的直接接触。本研究结果将发表在同行评议的期刊上。它们将使医疗保健提供者更好地了解非重症急性胰腺炎疼痛治疗的最佳镇痛药物。
