Best Practices for Chronic Pancreatitis Pain Management: A Comprehensive Evidence-Based Review

Pei-Yu Huang,1,* Ai-Fang Xiao,1,* Zhen-Qing Ren,2 Lu Chen,2 Li Ding,1 Cong Li1 1Department of Emergency, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China; 2Department of Nursing, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lu Chen, Department of Nursing, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, No. 366 Taihu Road, Pharmaceutical High-tech Zone, Taizhou, 225300, People’s Republic of China, Tel +8613641589385, Email [email protected] Zhen-Qing Ren, Department of Nursing, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, No. 366 Taihu Road, Pharmaceutical High-tech Zone, Taizhou, 225300, People’s Republic of China, Tel +8613515157666, Email [email protected]: This study aimed to identify and synthesize high-quality evidence regarding pain management in individuals with chronic pancreatitis (CP) to serve as a reference for clinical practice interventions.Methods: A thorough review encompassing databases, clinical guidelines, and information platforms, such as UpToDate, Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), guide.medlive.cn, PubMed, Embase, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure (CNKI), and Wanfang Data, was conducted to gather relevant evidence on pain management in CP. The search encompassed clinical decisions, evidence summaries, guidelines, systematic reviews, and expert consensus documents published up to October 2023. Two researchers independently evaluated included articles and extracted data pertinent to clinical practice.Results: In total, 21 articles met the inclusion criteria for final analysis, comprising four guidelines, two expert consensus documents, one clinical decision, and 14 systematic reviews. The evidence was categorized into seven key treatment domains: pain evaluation, drug intervention, endoscopic treatment, surgical intervention, Traditional Chinese Medicine (TCM) therapies, other treatment modalities, and approaches tailored to specific populations. 19 individual recommendations were derived from these categories.Conclusion: This review consolidates the best available evidence for pain management in CP. However, in clinical application, the optimal intervention should be individualized, taking into account patient preferences, the healthcare institution’s technical capabilities, and other relevant factors. This approach is crucial for optimizing pain management and enhancing the quality of life in individuals with CP.Keywords: abdominal pain, chronic pancreatitis, evidence-based medicine, evidence summary, pain management