Comparison of Buprenorphine and Diclofenac for acute pancreatitis pain

Buprenorphine found to be effective in relieving pain in patients with moderate to severe acute pancreatitis (inflammation of the pancreas).

This study aimed to compare the efficacy of Buprenorphine, an opioid, and Diclofenac, an NSAID, in alleviating pain associated with acute pancreatitis.

As a part of a double-blind randomized controlled trial, patients with acute pancreatitis were randomly assigned to receive either Diclofenac or Buprenorphine intravenously. Fentanyl was available as rescue analgesia administered via a patient-controlled analgesia pump.

The primary outcome measure was the dissimilarity in the amount of rescue Fentanyl needed. Secondary outcomes included the number of successful and unsuccessful demands for rescue fentanyl, duration of pain relief, reduction in visual analogue scale (VAS) pain scores, occurrence of adverse events, and development of organ failure.

Forty-eight patients were assigned randomly to receive either Diclofenac or Buprenorphine (24 in each group). The Buprenorphine group required significantly less rescue Fentanyl (130 μg) compared to the Diclofenac group (520 μg). Patients in the Buprenorphine group also had fewer demands (8 demands) compared to those in the Diclofenac group (32 demands).

Compared to the Diclofenac group, the pain relief lasted longer in the Buprenorphine group (20 hours vs 4 hours) with a greater reduction in pain scores on day 1, day 2 and day 3. These results were consistent even in patients with moderately severe or severe pancreatitis. The incidence of side effects was similar in both treatment groups.

Buprenorphine was more effective than Diclofenac for managing pain in patients with acute pancreatitis. These therapies are as safe, even for those with more severe cases of the condition.