Acute pancreatitis is an acute inflammatory process which affects the pancreas. The guiding symptom is acute abdominal pain, usually located in the epigastrium and radiating like a belt. The pain is often so severe that patients have to go to Accident and Emergency, and are then admitted to hospital. Due to the severity, particularly in the first hours, adequate pain control is crucial in managing this condition. However, despite the high and increasing incidence of acute pancreatitis and it being one of the leading reasons for admission for gastrointestinal causes,1 there are few descriptive studies on how to manage the associated pain. Evidence on the type of drugs to be used to control such pain is also limited, as the published studies comparing efficacy and safety of different analgesics are very heterogeneous and only include small numbers of subjects.2, 3, 4, 5, 6, 7, 8, 9, 10 Review of studies, mostly with different opioids, has shown that morphine and opioids are safe for pain control in acute pancreatitis.11, 12 The classic paradigm which says morphine in particular, and opioids in general, should be avoided in acute pancreatitis due to the potential for inducing sphincter of Oddi dysfunction has thus been cast aside. In the absence of specific recommendations for pain management in acute pancreatitis, the WHO analgesic scale is often applied. However, there are marked geographical differences in the availability and acceptability of different drugs.

Our aim was to explore how acute pancreatitis pain is managed in our setting by analysing which drugs are most commonly used and any differences which may exist, according to the characteristics of the prescribing physician or the medical centre.