European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations
Abstract
Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high‐quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non‐opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.
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BibTeX
@article{pandanaboyana2026european,
title = {{European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations}},
author = {Sanjay Pandanaboyana and Cecilie Siggaard Knoph and Louise Kuhlmann and Patrice Forget and Esther Pogatzki-Zahn and Wei Huang and Stefanos Bonovas and Daniele Piovani and Isabelle Scheers and Karina Cárdenas-Jaén and Sara Regner and Asbjorn Mohr Drewes},
journal = {United European Gastroenterology Journal},
year = {2026},
month = jun,
doi = {10.1002/ueg2.70230},
url = {https://hal.science/hal-05800003v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations
AU - Sanjay Pandanaboyana
AU - Cecilie Siggaard Knoph
AU - Louise Kuhlmann
AU - Patrice Forget
AU - Esther Pogatzki-Zahn
AU - Wei Huang
AU - Stefanos Bonovas
AU - Daniele Piovani
AU - Isabelle Scheers
AU - Karina Cárdenas-Jaén
AU - Sara Regner
AU - Asbjorn Mohr Drewes
PY - 2026
DA - 2026/06/16
JO - United European Gastroenterology Journal
DO - 10.1002/ueg2.70230
UR - https://hal.science/hal-05800003v1
AB - Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high‐quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non‐opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.
SN - 2050-6406
SN - 2050-6414
ER -