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Abstract
The article discusses modern methods of dealing with pain, the most common symptom and main complaint of patients with acute pancreatitis (AP). The existing methods of correcting pain syndrome with the help of various analgesic combinations using both non-narcotic and narcotic analgesics are considered. Particular attention is paid to the use of analgesic drugs from three pharmaceutical groups: non-steroidal anti-inflammatory drugs, opioid analgesics and local anesthetics. The advantages and disadvantages of prescribing each group of drugs are discussed. It is indicated that non-steroidal anti-inflammatory drugs are first-line analgesics, while opioids should be considered in case of persistent and/or intense pain that is not relieved by non-opioid drugs. The article emphasizes that weak opioids such as mixed agonists/antagonists or partial agonists (tramadol) should be preferred first, while stronger opioids (morphine, meperidine, sufentanil) should be used second. Sufentanil can be recommended as a powerful opioid with a high therapeutic index. The article presents modern algorithms for the selection and administration of analgesic combinations, discusses the indications for epidural anesthesia in acute pain, which is an effective method of pain relief and helps to significantly reduce the intensity of the inflammatory process and improve outcomes in patients with acute pain. To reveal the strengths of a multistage multimodal approach to pain relief in acute pain. The use of this multimodal analgesic regimen has several advantages: reducing the need for opioids and reducing the incidence of opioid-induced complications, effective pain control, which potentially reduces the risk of complications associated with insufficient analgesia.
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