title: Effects of systemic administration of a local anesthetic on pain in acute pancreatitis: a randomized clinical trial.
abstract: OBJECTIVE
  Intravenous local anesthetics may ameliorate pain and clinical course in patients with major abdominal surgery.
  
  
  OBJECTIVE
  To investigate their effects in acute pancreatitis.
  
  
  METHODS
  Forty-six consecutive patients with acute pancreatitis randomly received intravenous procaine (2 g/24 h) or placebo for 72 hours in a double-blind fashion. Pain severity (visual analog scale, 0-100), on-demand pain medication (metamizole and/or buprenorphine), and the clinical course were monitored every 24 hours.
  
  
  RESULTS
  Data of 44 patients were subjected to intention-to-treat analysis. Although there were no differences between groups before treatment, procaine treatment was associated with a stronger decrease in pain compared with placebo (median visual analog scale decrement, -62 vs -39, P = 0.025). Moreover, there was a greater proportion of patients with adequate (≥ 67%) pain reduction (75% vs 43%, P = 0.018), less use of additional analgesics (P = 0.042), and overall analgesic superiority (P = 0.015). Compared with placebo, the proportion of patients hospitalized after 2 weeks was reduced by 80% after procaine treatment (P = 0.012).
  
  
  CONCLUSIONS
  These findings support the hypothesis that systemic administration of local anesthetics might improve pain and accelerate clinical recovery in acute pancreatitis.
authors.affiliation: Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany. Layer@ik-h.de
authors.forename: Peter
authors.initials: P
authors.lastname: Layer
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Bronisch
authors.forename: Utah Maria
authors.initials: UM
authors.lastname: Henniges
authors.forename: Imtraut
authors.initials: I
authors.lastname: Koop
authors.forename: Matthias
authors.initials: M
authors.lastname: Kahl
authors.forename: Axel
authors.initials: A
authors.lastname: Dignass
authors.forename: Christian
authors.initials: C
authors.lastname: Ell
authors.forename: Marc
authors.initials: M
authors.lastname: Freitag
authors.forename: Jutta
authors.initials: J
authors.lastname: Keller
mesh_terms: D000700:Analgesics / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D010195:Pancreatitis / Q000188:drug therapy* / Q000503:physiopathology*; D011343:Procaine / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D011343:Procaine