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2. Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

Author

Knoph, Cecilie Siggaard, Lucocq, James, Kamarajah, Sivesh Kathir, Olesen, Søren Schou, Jones, Michael, Samanta, Jayanta, Talukdar, Rupjyoti, Capurso, Gabriele, de‐Madaria, Enrique, Yadav, Dhiraj, Siriwardena, Ajith K., Windsor, John, Drewes, Asbjørn Mohr, Nayar, Manu, Cark, Neil, Pius, Riinu, Houghton, Eduardo, Gimenéz, Mariano, Uribe, Karla, Rodriguez, Florencia, Gundara, Justin, Mackay, Thomas, Phan, Huynh, Lewin, Joel, McElhatton, Claire, Siriwardhane, Mehan, Hodgson, Russell, Malik, Hassan, Ward, Ryan, Young, Kerilee, Bappayya, Shaneel, Loveday, Benjamin, Samra, Jaswinder, Gall, Tamara, Mittal, Anubhav, Chan, Ting Ting, Lo, Vincent Wing‐ho, Liang, Hui, Wang, Cong, Huang, Wei, Jin, Tao, Wu, Yongzi, Xia, Qing, Georgio, Nikolaou, Koronakis, Nikolaos, Davidsen, Line, Hamed, Emad, Mohamed, Salem, Demetrashvili, Zaza, Tvaladze, Ana, Kachakhidze, Irakli, Zurabashvili, Tea, Ioannidis, Orestis, Kapiris, Stylianos, Mavrodimitraki, Eleni, Sotiropoulou, Maria, Machairas, Nikolaos, Schizas, Dimitrios, Syllaios, Athanasios, Vailas, Michail, Chlorakis, Georgios, Kalaitzakis, Evangelos, Tsafaridou, Maria, Mulita, Francesk, Verras, Georgios‐Ioannis, Gupta, Amit, Rajput, Deepak, Sharma, Oshin, Goud, Rajesh, Unnisa, Misbah, Bains, Lovenish, Singh, Nishu, Dhar, Jahnvi, Abdelmoeti, Mahmoud, Súilleabháin, Criostóir Ó, O'Connell, Robert, Calabro, Marcello, La Terra, Antonio, Muretore, Andrea, Contul, Riccardo Brachet, Diotallevi, Margherita, Mascaro, Annamaria, Millo, Paolo, Biondo, Santino Antonio, Mazzeo, Carmelo, Cucinotta, Eugenio, Fleres, Francesco, Marinak, AOUG, Brocco, Veronica, Ceresoli, Marco, Rennis, Maria, Centonze, Danilo, Distefano, Coatanza, Veroux, Massimiliano, Zerbo, Domenico, Bogoni, Selene, Biloslavo, Alan, Bianchi, Velentina, Candelli, Marcello, Franceschi, Francesco, Gasbarrini, Antonio, Nista, Enrico, Sganga, Gabriele, Tropeano, Giuseppe, Policlinico, Fondazione, Altieri, Caterina, Dinuzzi, Vincenza, Marconi, Matteo, Rivolta, Umberto, Dameno, Vitale Roberto, Papa, Mario V., Balla, Andrea, Lepiane, Pasquale, Saraceno, Federica, Aiolfi, Alberto, Bona, Davide, Sozzi, Andrea, Cianci, Pasquale, Varesano, Marco, Conversano, Ivana, Abete, Roberta, D'Avino, Raffaele, Marra, Ester, Marte, Gianpaolo, Tammaro, Pasquale, Gobatti, Davide, Marmaggi, Serena, Palmieri, Francesco, Sampietro, Roberto, Manca, Roberto, Pilla, Federica, Piras, Enrico, Pignata, Giusto, Canfora, Ilaria, Andreuccetti, Jacopo, D'Alessio, Rossella, Armellin, Claudia, Grossi, Ugo, Massani, Marco, Pontin, Alessandro, Stecca, Tommaso, Pilia, Tiaizna, Pisanu, Adolfo, Podda, Mauro, Giuffrida, Mario, Perrone, Gennaro, Guadagni, Simone, Morelli, Luca, Frontali, Alice, Basurto, Francesca, D'Ugo, Stefano, Manoochehri, Farshad, Spampinato, Marcello, Apadula, Laura, Preatoni, Paoletta, Sartarelli, Lodovico, Al‐Jaiuossi, Osama, Ernisova, Mairam, Sopuev, Andrey, Sua, Bruce, Farfus, Anthony, Teo, Keith, Smith, Brittany, Ratnayake, Bathiya, Buchanan, Jayvee, Clark, Elinor, Connor, Saxon, Hore, Todd, Attari, Salman, Kadir, Bushra, Memon, Sadik, Abbas, Zaigham, Quadeer, Muhammad Ali, Altaf, Abeer, Ameet, Pooja, Devi, Jalpa, Seerani, Nandlal, Afzal, Ameer, Akbar, Ali, Asghar, Mohammad Sohail, Sa, Tiago, Barreira, Ana Lucia, Carvalho, Numo, Cismasiu, Brigitta, Henriques, Susana, Luiz, Francisco Vara, Draghici, Andreea, Grigorean, Valentin, Porojan, Vlad, Stoian, Alexandru‐Rares, Teaca, Lucia, Arbutina, Dragana, Cuk, Vladica, Kovacevic, Bojan, Mandic, Luka, Bonney, Glenn, Gao, Yujia, Pang, Ning Qi, Bellil, Abdalla, Devar, John, Khan, Zafar, Khumalo, Vusi, Smith, Martin, Estevez‐Fernandez, Sergio, Mosquera, Beatriz Romero, Rodriguez, Sergio, Garcia‐Rayado, Guillermo, Piñerua‐Gonsalvez, Jean Felix, Ruiz Rebollo, M Lourdes, Olmos, Jose M., Tejedor‐Tejada, Javier, Diez‐Alonso, Manuel, Matias‐Garcia, Belen, Moreno, Fernando Mendoza, Vera‐Mansilla, Cristina, Roses, Helena Salvador, Gómez, Diego Vázquez, Oballe, Juan Rodriguez, Jayarajah, Umesh, Nandasena, Malith, Pathirana, Aloka, Galal‐Eldin, Sami, Hajibandeh, Shahab, Hamid, Hytham, Colak, Elif, Sydorchuk, Larysa, Knut, Ruslan, Voronyuk, Ksenia, Chooklin, Serge, Baryskyi, Vitalii, Sydorchuk, Ruslan, Mukherjee, Samrat, Patel, Maitreyi, Akhtar, Amina, Asarbakhsh, Miriam, Nolan, Frances, Schuijtvlot, Nicholaas, Prem, Sandhya, Thrikandiyur, Anuradha, Morris, Millicent, Mroczek, Thomas, Sgourakis, George, Sultana, Asma, Varley, Rebecca, Groot‐Wassink, Thomas, Labinoti, Roland, Packham, Brett, Seebah, Keving, Allen, Sophie, Mokhtassi, Shiva, Belgaumkar, Ajay, De'Ath, Henry, Cook, Amy, Delaney, Christopher, Johnson, Roisin, Azibaodinami, Becky Olali, Sartini, Ashley, Stanfield, Mea, Tomasi, Ivan, Kanakala, Venkat, Mbarushimana, Simon, McKeever, Mark, Batilli, Mamata, Bhatta, Gakul, Rai, Subash, Bond‐smith, Giles, Elserafy, Amr, Shams, Mohamed, Al Saoudi, Tareq, Bhardwaj, Neil, Hussain, Wajith, Lancellotti, Francesco, Montagnini, Greta, Cairns, George, Hollyman, Marianne, Rakin, Asef, Shahid, Mishal, Barbour, Fraser, Hawkyard, Jake, McTeer, Matthew, Pandanaboyana, Sanjay, Taylor, Ellie, Kuzman, Matta, Dyer, Sarah, Hopkins, James, Pournaras, Dimitri, Sudlow, Alexis, Kumar, SK, Aujayeb, Avinash, Leo, Alex, Senra, Fatima Lorenzana, Watfah, Josef, Barrie, Jenifer, Brown, Chris, Gomez, Dhanny, Aroori, Somaiah, Ciprani, Debora, Karmarkar, Rahi, Almomani, Eyas, Roberts, Keith, Fale, Madeleine, Gupta, Ajay, Marsden, Max, Seet, Chris, Soni, Lakshya, Hamdan, Mohammed, Sadera, Rohan, Sud, Vikas, Chinnah, Edith, Di Mauro, Davide, Manzelli, Antonio, Orabi, Amira, Presa, Roberto, Reece‐Smith, Alex, Wajed, Shahjehan, Fingret, Jacob, Shah, Nehal, Jatania, Jignesh, Krishna, Arun, Berry, David, Kitsikosta, Loukiani, Helliwell, Jack, Huntley, Benjamin, Pine, James, Yau, Jih‐Dar, Lee, Shiela, Mahawar, Kamal, Shetty, Neehar, Britton, Emily, Shaw, Alice, Laarhoven, Stijn, Gahunia, Sukhpreet, Ortega, Miguel Gargia, Lee, Adam, Ng, Cho Ee, El Kafsi, Jihene, Mason, John, Vithlani, Gauri, Benhmida, Rami, Gunell, James, Parmar, Chetan, Dorkeh, Da‐Costa, Elnagar, Mohamed, Lee, Jih Ian, Nessa, Ashrafun, Yeap, Zhu Hui, Hemadasa, Niroshini, Javed, Saria, Sami, Sharuk, Damaskos, Dimitrios, Healey, Andrew, Soupashi, Maria, Triantafyllou, Tania, Coats, Maria, Douglass, Benjamin, Hendry, Brid, Hussain, Yasmin, Javid, Zhara, Mantyla, Mia, Rajkumar, Khaman, Chin, Carven, Hajibandeh, Shahab, Kumar, Nagappan, Gerogiannis, Ioannis, Kapsampelis, Panagiotis, Gerge, Farid, Anderson, Gulsum, Dinh, Vu, Phillips, Anna, Yadav, Dhiraj, and Pandanaboyana, Sanjay

Abstract

Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1‐month follow‐up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p< 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p< 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre‐admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p< 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p= 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre‐admission pain duration, acute necrotic collections, and walled‐off necrosis also increased the likelihood of opioid prescription at discharge. There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.

Published
2024
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3. Vessel skeletonization in lateral pelvic lymph node dissection for male and female patients with anomalous anatomy following neoadjuvant treatment for locally advanced rectal cancer – A video vignette.

Author

Karagiannidis, Georgios, Alghazawi, Laith, Labinoti, Roland, and Malik, Arshad

Subjects
PATIENTS, LYMPHADENECTOMY, NEOADJUVANT chemotherapy, EDITING software, RECTAL cancer, HUMAN dissection
Abstract

This article, titled "Vessel skeletonization in lateral pelvic lymph node dissection for male and female patients with anomalous anatomy following neoadjuvant treatment for locally advanced rectal cancer – A video vignette," discusses the nuances of lateral pelvic node dissection in patients with rectal cancer who have undergone neoadjuvant treatment. The video presentation focuses on the meticulous "skeletonization" of iliac vessels in both male and female patients, highlighting the anatomical differences between the sexes. The authors emphasize the importance of understanding and navigating anatomical variations, particularly in challenging operative anatomical sites such as the pelvic sidewalls. The video aims to provide valuable insights for colorectal surgeons specializing in surgery beyond total mesorectal excision in the pelvis. [Extracted from the article]

Published
2024
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