Effects of Systemic Administration of a Local Anesthetic on Pain in Acute Pancreatitis A Randomized Clinical Trial

被引:28
作者
Layer, Peter [1 ]
Bronisch, Hans-Joachim [2 ]
Henniges, Utah Maria [1 ]
Koop, Imtraut [3 ]
Kahl, Matthias [1 ]
Dignass, Axel [4 ]
Ell, Christian [5 ]
Freitag, Marc [6 ]
Keller, Jutta [1 ]
机构
[1] Israelit Hosp Hamburg, Dept Internal Med, D-22297 Hamburg, Germany
[2] Katholisches Krankenhaus St Nepomuk, Dept Internal Med, Erfurt, Germany
[3] Amalie Sieveking Krankenhaus, Dept Internal Med, Hamburg, Germany
[4] Markus Krankenhaus, Dept Gastroenterol, Frankfurt, Germany
[5] Horst Schmidt Kliniken, Dept Gastroenterol, Wiesbaden, Germany
[6] Israelit Hosp, Dept Anaesthesiol, D-22297 Hamburg, Germany
关键词
acute pancreatitis; local anesthetic; analgesia; clinical course; randomized controlled trial; MORTALITY; LIDOCAINE; GUIDELINES; PROCAINE; INDEX;
D O I
10.1097/MPA.0b013e318215ad38
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives: Intravenous local anesthetics may ameliorate pain and clinical course in patients with major abdominal surgery. Aim: To investigate their effects in acute pancreatitis. Methods: Forty-six consecutive patients with acute pancreatitis randomly received intravenous procaine (2 g/24 h) or placebo for 72 hours in a double-blind fashion. Pain severity (visual analog scale, 0-100), on-demand pain medication (metamizole and/or buprenorphine), and the clinical course were monitored every 24 hours. Results: Data of 44 patients were subjected to intention-to-treat analysis. Although there were no differences between groups before treatment, procaine treatment was associated with a stronger decrease in pain compared with placebo (median visual analog scale decrement, -62 vs -39, P = 0.025). Moreover, there was a greater proportion of patients with adequate (>= 67%) pain reduction (75% vs 43%, P = 0.018), less use of additional analgesics (P = 0.042), and overall analgesic superiority (P = 0.015). Compared with placebo, the proportion of patients hospitalized after 2 weeks was reduced by 80% after procaine treatment (P = 0.012). Conclusions: These findings support the hypothesis that systemic administration of local anesthetics might improve pain and accelerate clinical recovery in acute pancreatitis.
引用
收藏
页码:673 / 679
页数:7
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