Causes and Management of Acute Pancreatitis Pain in the Intensive Care Unit

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Abstract
AP is a mild to severe, potentially life-threatening condition caused by inflammation of the pancreas. Most common causes are excessive alcohol consumption and gallstone disease. For patients in intensive care, pain relief is a priority, as one of the main symptoms of AP is severe, often unbearable abdominal pain. Adequate pain management not only improves patients’ comfort but also reduces the systemic stress response and the risk of late complications. The mechanism of pain is complex, with several factors contributing: enzymatic autodigestion, inflammation, oedema, ischaemia and neuronal sensitivity. Intense pain increases the incidence of SIRS, which may also lead to the development of MODS. The main methods of analgesia include: nonopioid analgesics (paracetamol, NSAIDs); opioids: (fentanyl, remi and sufentanyl but their long-term use should be avoided due to their known complications and side effects. Lidocaine infusion, a potent anti-inflammatory and analgesic, is not currently in daily use due to its dangerousness. Epidural analgesia is the most effective and commonly used procedure for severe pain. Appropriate pain management can reduce complications of AP, including sepsis and long hospital stays, and improve patients’ chances of survival and quality of life.

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