Assessment of Add-On Therapy of N-Acetylcysteine in the Management of Acute Pancreatitis

Background Acute pancreatitis (AP) is an inflammation of the pancreas. The conservative therapeutic options include enteral nutrition, antibiotics, and/or surgery. Oxidative stress in AP has been pathologically linked with the systemic inflammatory response. N-acetylcysteine (NAC), an antioxidant, attenuates oxidative stress-induced cell injury and other potential pathological events in AP. Objective This article evaluates the treatment outcome of NAC combined with conventional therapy in AP patients and assesses the difference in the duration of hospital stay between the NAC with conventional therapy group and the conventional therapy group. Materials and Methods This observational study was conducted in a tertiary care hospital with 65 AP patients above 18 years of age. The effect of adding NAC with conventional therapy (intravenous hydration 0.9% normal saline, pancreatin, optional antibiotics) was assessed in patients by comparing serum amylase, lipase, Acute Physiology and Chronic Health Examination (APACHE) II score, and Ranson's score, before and after therapy and the difference in duration of hospital stay was assessed using the independent t -test. Results Of the 65 AP patients, 62% ( n = 40) were on conventional therapy and 38% ( n = 25) were on NAC along with conventional therapy. The difference in mean values of reduced serum amylase between the two treatment groups indicates a significant difference ( p = 0.01). However, the variance in mean serum lipase values was statistically insignificant ( p = 0.1). The mean scores of Ranson's criteria showed no significant difference between both groups ( p = 0.4). There was a significant difference in APACHE II severity scores after 24 ( p = 0.04) and 48 hours ( p = 0.01), respectively. Similarly, the mean duration of hospital stay in both treatment groups was found to be statistically insignificant ( p = 0.4). Conclusion Both treatment options, conventional therapy and NAC combined with conventional therapy, resulted similar treatment outcomes for AP patients, with no additional benefits observed.