16. Pain in chronic pancreatitis
Pain Practice,
Год журнала:
2025,
Номер
25(4)
Опубликована: Апрель 1, 2025
Abstract
Introduction
Chronic
pancreatitis
is
defined
as
a
disease
of
the
pancreas
in
which
recurrent
inflammatory
episodes
result
replacement
pancreatic
parenchyma
by
fibrous
connective
tissue
individuals
with
genetic,
environmental,
and
other
risk
factors.
Pain
one
most
important
symptoms
chronic
and,
many
cases,
has
visceral
nociceptive,
nociplastic,
even
neuropathic
components,
evidence
both
central
peripheral
sensitization,
neuroplasticity,
neurogenic
inflammation.
Methods
The
literature
on
diagnosis
treatment
pain
was
reviewed
summarized.
Results
Treatment
abdominal
guided
morphology
imaging,
although
correlation
between
pathoanatomical
changes
not
always
straightforward.
Patients
duct
obstruction
are
initially
offered
endoscopic
or
surgical
therapies,
while
non‐obstructive
mostly
managed
medically.
Lifestyle
psychological
support
particular
importance
for
all
patients.
Analgesic
options
range
from
non‐opioid
medications
to
opioids
adjuvant
agents.
Interventional
management
may
consist
radiofrequency
splanchnic
nerves
spinal
cord
stimulation.
To
date,
there
no
randomized
trials
supporting
their
efficacy
pain,
recommendation
consider
these
justified
observational
studies.
Possible
opioid‐sparing
effects
interventional
treatments
because
opioid
use
dependency
common
patients
associated
worse
outcomes.
Celiac
plexus
block
generally
recommended
due
limited
quality
evidence,
overall
short
duration
effect,
invasiveness
procedure.
Central
sensitization
can
impact
effectiveness
invasive
treatments.
Conclusions
Managing
complex
task
that
requires
multidimensional
individualized
approach.
Due
lack
trials,
decisions
often
expert
opinion.
Integrating
pharmacological
non‐pharmacological
interventions
collaborating
multidisciplinary
team
key
components
effective
management.
Язык: Английский
Causes and Management of Acute Pancreatitis Pain in the Intensive Care Unit
IntechOpen eBooks,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 8, 2025
AP
is
a
mild
to
severe,
potentially
life-threatening
condition
caused
by
inflammation
of
the
pancreas.
Most
common
causes
are
excessive
alcohol
consumption
and
gallstone
disease.
For
patients
in
intensive
care,
pain
relief
priority,
as
one
main
symptoms
often
unbearable
abdominal
pain.
Adequate
management
not
only
improves
patients’
comfort
but
also
reduces
systemic
stress
response
risk
late
complications.
The
mechanism
complex,
with
several
factors
contributing:
enzymatic
autodigestion,
inflammation,
oedema,
ischaemia
neuronal
sensitivity.
Intense
increases
incidence
SIRS,
which
may
lead
development
MODS.
methods
analgesia
include:
nonopioid
analgesics
(paracetamol,
NSAIDs);
opioids:
(fentanyl,
remi
sufentanyl
their
long-term
use
should
be
avoided
due
known
complications
side
effects.
Lidocaine
infusion,
potent
anti-inflammatory
analgesic,
currently
daily
its
dangerousness.
Epidural
most
effective
commonly
used
procedure
for
severe
Appropriate
can
reduce
AP,
including
sepsis
long
hospital
stays,
improve
chances
survival
quality
life.
Язык: Английский