Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Adults with acute pancreatitis ᵃ
Intervention: Opioids ᵇ
Comparison: Non-opioid analgesics ᵇ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Number of participants showing improvements in pain intensity at 2 days | No statistically significant difference | Low |
Number of participants with a supplementary analgesic option offered at 2-4 days | No statistically significant difference ᶜ | Low |
Number of participants with pancreatitis complications at 2-4 days | No statistically significant difference | Low |
Number of participants with drug-related adverse events at 2-3 days | No statistically significant difference | Low |
Number of deaths from any cause | No statistically significant difference | Very Low |
Note The Cochrane Clinical Answer (CCA) notes that the majority of included studies were underpowered. ᵃ Sixty-five percent men. ᵇ The included studies used the following opioids: intravenous buprenorphine, subcutaneous morphine, or intravenous pentazocine. These were compared with intravenous non-opioid analgesics, procaine, or metamizole. ᶜ Although not statistically significant, fewer people required supplementary analgesia with opioid analgesia (30 per 100 people) compared with non-opioid analgesia (73 per 100 people). See CCA for more details.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How does early routine endoscopic retrograde cholangiopancreatography compare with early conservative management in people with acute gallstone pancreatitis?
- How do opioids compare with non-opioid analgesics for the management of acute pancreatitis pain?
- Can the pancreatic duct guidewire technique for biliary cannulation help to prevent ERCP pancreatitis?
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