European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis : UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations
(2026) In United European Gastroenterology Journal 14(5).- Abstract
Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by... (More)
Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non-opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.
(Less)
- author
- Pandanaboyana, Sanjay
; Knoph, Cecilie Siggaard
; Kuhlmann, Louise
; Forget, Patrice
; Pogatzki-Zahn, Esther
; Huang, Wei
; Bonovas, Stefanos
; Piovani, Daniele
; Scheers, Isabelle
; Cárdenas-Jaén, Karina
; Regner, Sara
LU
and Drewes, Asbjorn Mohr
(Less) - author collaboration
- organization
- publishing date
- 2026-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acupuncture, epidural analgesia, guidelines, pain, pancreatitis, pediatrics
- in
- United European Gastroenterology Journal
- volume
- 14
- issue
- 5
- article number
- e70230
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:42299777
- scopus:105042338219
- ISSN
- 2050-6406
- DOI
- 10.1002/ueg2.70230
- language
- English
- LU publication?
- yes
- id
- 026f7363-9cee-4f8f-adb5-393e1e442bb1
- date added to LUP
- 2026-07-02 14:04:08
- date last changed
- 2026-09-10 20:03:08
@article{026f7363-9cee-4f8f-adb5-393e1e442bb1,
abstract = {{<p>Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non-opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.</p>}},
author = {{Pandanaboyana, Sanjay and Knoph, Cecilie Siggaard and Kuhlmann, Louise and Forget, Patrice and Pogatzki-Zahn, Esther and Huang, Wei and Bonovas, Stefanos and Piovani, Daniele and Scheers, Isabelle and Cárdenas-Jaén, Karina and Regner, Sara and Drewes, Asbjorn Mohr}},
issn = {{2050-6406}},
keywords = {{acupuncture; epidural analgesia; guidelines; pain; pancreatitis; pediatrics}},
language = {{eng}},
number = {{5}},
publisher = {{John Wiley & Sons Inc.}},
series = {{United European Gastroenterology Journal}},
title = {{European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis : UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations}},
url = {{http://dx.doi.org/10.1002/ueg2.70230}},
doi = {{10.1002/ueg2.70230}},
volume = {{14}},
year = {{2026}},
}