Buprenorphine or Procaine for Pain Relief in Acute Pancreatitis A Prospective Randomized Study

Jakobs, Ralf; Adamek, Mariusz; Bubnoff, A. C. Von; Riemann, J. F.

doi:10.1080/003655200453692

Cited by 95 publications

(39 citation statements)

References 13 publications

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“…We confirm and extend findings from a previously published smaller study that reported procaine to be less effective than buprenorphine in the treatment of pain in patients with AP [7]. Patients with an AP usually suffer from severe abdominal pain and therefore a major treatment goal is rapid onset and potent pain relief.…”

Section: Discussionsupporting

confidence: 80%

“…However, there are no prospective trials proving any beneficial effect of intravenously administered procaine on pain in patients with AP. In a recent small study, procaine was proven to be less effective compared to other drugs [7]. We therefore performed a clinical trial to evaluate the efficacy of procaine compared to pentazocine for pain control in patients with AP.…”

Section: Introductionmentioning

confidence: 99%

“…Effective pain control in AP is part of the basic supportive therapy (volume replacement, rehydration). There are several treatment options recommended for pain control in AP [1, 2, 3, 4, 5, 6], but only a few clinical trials have addressed these options to be either effective or not for pain relief in patients with AP [7, 8, 9, 10]. …”

Section: Introductionmentioning

confidence: 99%

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Procaine Hydrochloride Fails to Relieve Pain in Patients with Acute Pancreatitis

Kahl¹,

Zimmermann²,

Pross³

et al. 2004

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Background: Several analgesics are in use for pain control in patients with acute pancreatitis. Procaine hydrochloride (procaine) has a long tradition and is recommended by the German Society of Gastroenterology and Metabolic Diseases for pain treatment in patients with acute pancreatitis. There is no controlled trial showing that procaine could be effective for pain treatment. Methods: In an open, randomized, controlled trial, 107 patients (76 male, 31 female; mean age 45 ± 12 years) were included and randomized either to receive procaine (n = 55) or pentazocine (n = 52) for pain relief. Procaine 2 g/ 24 h was administered by continuous intravenous infusion, pentazocine 30 mg was administered every 6 h as a bolus intravenous injection. Pentazocine was additionally administered on demand whenever required in patients of both treatment groups and its total consumption was recorded. Pain scores were assessed twice daily on a visual analogue scale. Results: Patients receiving procaine were significantly more likely to request additional analgesics compared to patients treated with pentazocine alone, 98 vs. 44%, respectively (p < 0.001). Procaine did not reduce the amount of pentazocine required for pain control. The amount of pentazocine given in both groups was not statistically significantly different. Recorded pain scores were significantly lower (p < 0.001) in patients in the pentazocine group during the first 3 days of analgesic treatment. From day 4 on there was no significant difference in pain scores among the two groups. Conclusion: Thus, intravenous procaine treatment is not effective for pain control in patients with acute pancreatitis.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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Procaine Hydrochloride Fails to Relieve Pain in Patients with Acute Pancreatitis

Kahl¹,

Zimmermann²,

Pross³

et al. 2004

Digestion

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“…There are no extensive studies on the pharmacological control of pain in acute pancreatitis patients [1,2,3,4], which is quite surprising given the importance of this symptom during the course of the disease. There is also a lack of evidence regarding the degree of efficacy of the various pharmacological substances used to treat the different forms of acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

NSAIDs and Acute Pancreatitis: A Systematic Review

2010

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The resulting pain is the main symptom of acute pancreatitis and it should be alleviated as soon as possible. NSAIDs are the first line therapy for pain and they are generally administered to acute pancreatitis patients upon admission to the hospital. In addition, these drugs have also been used to prevent post-endoscopic cholangiopancreatography (ERCP) acute pancreatitis. On the other hand, there are several reports indicating that NSAIDs may be the actual cause of acute pancreatitis. We carried out a literature search on PubMed/MEDLINE; all full text papers published in from January 1966 to November 2009 on the use of NSAIDs in acute pancreatitis were collected; the literature search was also supplemented by a review of the bibliographies of the papers evaluated. Thus, in this article, we will systematically review the current literature in order to better illustrate the role of NSAIDs in acute pancreatitis, in particular: i) NSAIDs as a cause of acute pancreatitis; ii) their use to prevent post-retrograde ERCP pancreatitis and iii) their efficacy for pain relief in the acute illness of the pancreas.

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“…In a first trial the effect of procaine on pancreatitis pain was compared to that of opiates and opiates were, not surprisingly, found to be much more effective [3]. The design of this trial, however, could not answer the question whether procaine had any effect on pain at all.…”

Section: Introductionmentioning

confidence: 99%

No More Intravenous Procaine for Pancreatitis Pain?

Lerch

2004

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Buprenorphine or Procaine for Pain Relief in Acute Pancreatitis A Prospective Randomized Study

Abstract: Constant i.v. application of buprenorphine is more effective than the recommended procaine for pain relief in acute pancreatitis.

Cited by 95 publications

References 13 publications

Procaine Hydrochloride Fails to Relieve Pain in Patients with Acute Pancreatitis

Procaine Hydrochloride Fails to Relieve Pain in Patients with Acute Pancreatitis

NSAIDs and Acute Pancreatitis: A Systematic Review

No More Intravenous Procaine for Pancreatitis Pain?

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