{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T03:25:08Z","timestamp":1767065108534,"version":"3.48.0"},"reference-count":29,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,30]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gastrointestinal hospitalisations in the USA cause over US$130\u2009billion 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081971","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T21:05:17Z","timestamp":1715634317000},"page":"e081971","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Analgesia for the treatment of acute pancreatitis: a protocol for a systematic review and network meta-analysis"],"prefix":"10.1136","volume":"14","author":[{"given":"Sriya S","family":"Subramani","sequence":"first","affiliation":[{"name":"Stead Family Department of Pediatrics, The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4577-9253","authenticated-orcid":false,"given":"Alaina C","family":"Berg","sequence":"additional","affiliation":[{"name":"The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee A","family":"Kral","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-5975","authenticated-orcid":false,"given":"Mohammad Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Smith","sequence":"additional","affiliation":[{"name":"Health Science Library, SUNY Upstate Medical University, Syracuse, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-5651","authenticated-orcid":false,"given":"Anna Evans","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburg, Pittsburg, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhiraj","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburg, Pittsburg, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliye","family":"Uc","sequence":"additional","affiliation":[{"name":"Stead Family Department of Pediatrics, Radiation Oncology, Fraternal Order of Eagles Diabetes Research Center, The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aamer","family":"Imdad","sequence":"additional","affiliation":[{"name":"Stead Family Department of Pediatrics, Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"2025121511235697000_14.5.e081971.1","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1053\/j.gastro.2018.12.043","article-title":"Pancreatitis in children","volume":"156","author":"Uc","year":"2019","journal-title":"Gastroenterology"},{"key":"2025121511235697000_14.5.e081971.2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1038\/nrgastro.2017.13","article-title":"What\u2019s unique about acute Pancreatitis in children: risk factors, diagnosis and management","volume":"14","author":"Husain","year":"2017","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2025121511235697000_14.5.e081971.3","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302779"},{"key":"2025121511235697000_14.5.e081971.4","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31824f1516"},{"key":"2025121511235697000_14.5.e081971.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.02.001"},{"key":"2025121511235697000_14.5.e081971.6","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001715"},{"key":"2025121511235697000_14.5.e081971.7","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S2468-1253(16)30004-8","article-title":"Global incidence and mortality of Pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies","volume":"1","author":"Xiao","year":"2016","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025121511235697000_14.5.e081971.8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.04.013"},{"key":"2025121511235697000_14.5.e081971.9","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.08.063"},{"key":"2025121511235697000_14.5.e081971.10","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1097\/MPA.0000000000000918","article-title":"Increased burden of pediatric acute Pancreatitis on the health care system","volume":"46","author":"Hornung","year":"2017","journal-title":"Pancreas"},{"key":"2025121511235697000_14.5.e081971.11","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.09.043"},{"key":"2025121511235697000_14.5.e081971.12","article-title":"Opioids for acute Pancreatitis pain","volume":"2013","author":"Basurto Ona","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121511235697000_14.5.e081971.13","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.36076\/ppj.2008\/11\/S105","article-title":"Opioid complications and side effects","volume":"2s;11","author":"Benyamin","year":"2008","journal-title":"Pain Phys"},{"key":"2025121511235697000_14.5.e081971.14","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/ejp.1515","article-title":"Comparison of efficacy of diclofenac and tramadol in relieving pain in patients of acute Pancreatitis: A randomized parallel group double blind active controlled pilot study","volume":"24","author":"Kumar","year":"2020","journal-title":"Eur J Pain"},{"key":"2025121511235697000_14.5.e081971.15","doi-asserted-by":"crossref","first-page":"192","DOI":"10.5152\/tjg.2015.150398","article-title":"Pain treatment in patients with acute Pancreatitis: A randomized controlled trial","volume":"27","author":"G\u00fclen","year":"2016","journal-title":"Turk J Gastroenterol"},{"key":"2025121511235697000_14.5.e081971.16","doi-asserted-by":"crossref","first-page":"813","DOI":"10.14309\/ajg.0000000000000224","article-title":"Pentazocine, a Kappa-opioid agonist, is better than diclofenac for analgesia in acute Pancreatitis: A randomized controlled trial","volume":"114","author":"Mahapatra","year":"2019","journal-title":"Am J Gastroenterol"},{"key":"2025121511235697000_14.5.e081971.17","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1007\/s00268-021-06420-w","article-title":"Analgesia in the initial management of acute Pancreatitis: A systematic review and meta-analysis of randomised controlled trials","volume":"46","author":"Thavanesan","year":"2022","journal-title":"World J Surg"},{"key":"2025121511235697000_14.5.e081971.18","doi-asserted-by":"crossref","first-page":"100002","DOI":"10.1016\/j.clirex.2019.100002","article-title":"A systematic review of NSAIDs treatment for acute Pancreatitis in animal studies and clinical trials","volume":"44S","author":"Wu","year":"2020","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"2025121511235697000_14.5.e081971.19","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2021.782151","article-title":"Pain management in acute Pancreatitis: A systematic review and meta-analysis of randomised controlled trials","volume":"8","author":"Cai","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"2025121511235697000_14.5.e081971.20","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1007\/s00268-022-06604-y","article-title":"Letter to the editor: analgesia in the initial management of acute Pancreatitis: A systematic review and meta-analysis of randomized controlled trials","volume":"46","author":"Ekakitie","year":"2022","journal-title":"World J Surg"},{"key":"2025121511235697000_14.5.e081971.21","doi-asserted-by":"crossref","first-page":"962671","DOI":"10.3389\/fphar.2022.962671","article-title":"Safety and efficacy of intravenous hydromorphone patient-controlled analgesia versus Intramuscular Pethidine in acute Pancreatitis: an open-label, randomized controlled trial","volume":"13","author":"Chen","year":"2022","journal-title":"Front Pharmacol"},{"key":"2025121511235697000_14.5.e081971.22","unstructured":"Covidence systematic review software, Veritas Health Innovation . Melbourne, Australia; 2023. Available: www.covidence.org"},{"key":"2025121511235697000_14.5.e081971.23","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l4898","article-title":"Rob 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"2025121511235697000_14.5.e081971.24","doi-asserted-by":"crossref","unstructured":"Chaimani A , Caldwell DM , Li T , et al . Undertaking network meta-analyses. Cochrane Handbook for Systematic Reviews of Interventions 2019;285\u2013320. doi:10.1002\/9781119536604","DOI":"10.1002\/9781119536604.ch11"},{"key":"2025121511235697000_14.5.e081971.25","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-016-1583-7"},{"key":"2025121511235697000_14.5.e081971.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.10.005"},{"key":"2025121511235697000_14.5.e081971.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.11.025"},{"key":"2025121511235697000_14.5.e081971.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.08.022"},{"key":"2025121511235697000_14.5.e081971.29","unstructured":"Gradepro GDT: Gradepro guideline development tool. McMaster University (developed by Evidence Prime, Inc.), Available: www.gradepro.org"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-081971","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:24:04Z","timestamp":1765826644000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-081971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1136\/bmjopen-2023-081971"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-081971","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}