Document Detail


Efficacy and tolerance of metamizole versus morphine for acute pancreatitis pain.
MedLine Citation:
PMID:  18235213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Morphine has been contraindicated for pain treatment in acute pancreatitis because of its presumed opioid-induced sphincter of Oddi dysfunction. However, scientific evidence supporting a deleterious influence on the clinical course is absent. This pilot study was undertaken to evaluate the efficacy and adverse events of metamizole versus morphine in acute pancreatitis. METHODS: 16 patients with acute pancreatitis were randomized to receive 10 mg/4 h s.c. (n = 8) morphine or 2 g/8 h i.v. (n = 8) metamizole. Pain scores were recorded every 4 h during 48 h after admission by a Visual Analogue Scale. Pethidine was additionally administered as a rescue therapy. RESULTS: 75% of patients achieved pain relief in the metamizole group versus 37.5% in the morphine group within 24 h of hospitalization (6/8 vs. 3/8; p: n.s.). The mean time to achieve pain relief was shorter in the metamizole group (10 +/- 6.6 vs. 17 +/- 18.3 h; p: n.s.). At the end of the study, 75% of patients achieved pain relief in the metamizole group versus 50% in the morphine group. Three patients in each group needed pethidine: 2 out of 3 achieved pain control in the metamizole group vs. 0 out of 3 in the morphine group. CONCLUSIONS: Intravenous metamizole shows a non-significant association with a quicker pain relief than morphine s.c. in acute pancreatitis. A larger randomized controlled trial should be desirable to confirm this result. and IAP.
Authors:
A M Peiró; J Martínez; E Martínez; E de Madaria; P Llorens; J F Horga; M Pérez-Mateo
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-01-31
Journal Detail:
Title:  Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]     Volume:  8     ISSN:  1424-3911     ISO Abbreviation:  Pancreatology     Publication Date:  2008  
Date Detail:
Created Date:  2008-04-24     Completed Date:  2008-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100966936     Medline TA:  Pancreatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  25-9     Citation Subset:  IM    
Copyright Information:
Copyright 2008 S. Karger AG, Basel.
Affiliation:
Clinical Pharmacology Unit, Hospital General Universitario de Alicante, Alicante, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics, Opioid / therapeutic use*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Dipyrone / therapeutic use*
Female
Humans
Male
Middle Aged
Morphine / therapeutic use*
Pain / drug therapy*,  etiology
Pancreatitis / complications*
Pilot Projects
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anti-Inflammatory Agents, Non-Steroidal; 57-27-2/Morphine; 68-89-3/Dipyrone

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