CHINESE JOURNAL OF MEDICINAL GUIDE ›› 2026, Vol. 28 ›› Issue (6): 695-695-703.doi: 10.1009-0959.2026.060005

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Pain Management in Acute Pancreatitis： Evidence-Based Progress from Conventional Pharmacotherapy to Precision Regional Anesthesia

SI Xu1， YANG Xiuli2*   

  1. 1.Henan Medical University， Henan Xinxiang 453003， China；
    2.The Third Affiliated Hospital of Henan Medical University， Henan Xinxiang 453003， China
  • Received:2026-04-14 Revised:2026-05-07 Accepted:2026-05-26 Online:2026-06-28 Published:2026-08-17

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Abstract:

Acute pancreatitis （AP） is one of the most common acute critical illnesses of the digestive system worldwide. The core clinical manifestation of AP is pain，and the quality of AP management directly affect patients' healthcare experience， length of hospital stay， medical costs， and long-term quality of life. Although both domestic and international guidelines and patients rank analgesia as the top clinical priority， the paucity of high-quality evidence-based evidence remains the most prominent bottleneck in this field. Conventional opioids have long dominated the analgesic management of AP， but they can cause contraction or spasm of the sphincter of Oddi， respiratory depression， intestinal paralysis， and addiction. In recent years， acetaminophen and non-steroidal anti-inflammatory drugs （NSAIDs） have regained attention for their dual analgesic and anti-inflammatory effects. Meanwhile， regional analgesic techniques within multimodal analgesia， namely thoracic epidural block （TEA）， transversus abdominis plane block （TAPB）， and erector spinae plane block （ESPB）， have garnered increasing research attention. These modalities present advantages in terms of analgesic efficacy， targeting specificity， opioid-sparing effect， potential organ protection， and controllability， and are evolving from an adjunctive approach to a core regimen in AP pain management.This study systematically reviews the evidence-based evidence on the pathophysiological mechanisms of AP-related pain， pain assessment tools， classification and selection of analgesic agents， drug administration routes， and regional analgesic techniques. It also analyzes optimized strategies for AP pain management stratified by disease severity， explores the implementation pathways of multimodal analgesia， and prospects the future directions of precision medicine， novel therapeutic targets， and artificial intelligence in AP analgesia，to identify clear directions for subsequent research in this field.


Key words: Acute pancreatitis； , Pain management； , Analgesia； , Multimodal analgesia； , Evidence-based medicine

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