THE APPLICATION OF BUPIENORPHINE IN ACUTE AND CHRONIC PANCPEATITIS

来源 :2015第八届全国ERCP学术研讨会暨第十一届中国西部国际治疗内镜高峰论坛 | 被引量 : 0次 | 上传用户:zhang_yingliang
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  Pancreatitis is an inflammation of the pancreas.The most common causes are alcohol consumption and gallstone related.Interestingly,pancreatitis is the most incidence observed in patients following abdominal surgery.The most frequently symptoms of pancreatitis are severe abdominal pain, nausea and vomiting.Heart and respiratory function may also be affected.How to reasonably choose a safe, effective and low-dependent analgesic is a big problem faced by the doctors.Analgesics will not affect the recovery of the disease if the patients have chronic or acute inflammation, however it will release the symptoms and make the patients more comfortable.In general, more than one type of analgesics are used in treating pancreatitis, such as acetaminophen, nonsteroidal anti-inflammatory drug and opioid etc., which is greatly controversial in clinical application because of the side effects such as ulcers associated with their use.In addition, some studies have shown that the use of opioid may conceal the changes of the disease and because their spasmogenic effects will increase the patients' ache, this in turn increases the sphincter pressure of oddi in abdominal cavity.The biliary tract pressure increase seems to be related with dosage and plasma concentration of opioid and seems to be apparently regulated by the Mu (μ) receptor.There is a subclass of opioid drug called buprenorphine hydrochlodde, along with its relatively outstanding pharmacologic character to be gradually known, buprenorphine can be used as substitute for the drug dolantin in treating the abdominal ache associated with acute and chronic pancreatitis.The use of burprenorphine can be an alternative choice to treat the aching of acute pancreatitis which has less side effects.Compared with other analgesia plans, buprenorphine can reduce analgesia metering needed, and which has no obvious differences in the risk of both the appearances of pancreatitis complication and clinical adverse events.According to the current clinical studies, buprenorphine is the suitable choice for treating the aching of acute pancreatitis, and compared with other analgesia drugs that are not belonging to opioid category.Currently for acute paroxysm associated with chronic pancreatitis, the common suggestions for treatment do not provide enough analgesia effect.Therefore the German Guide suggest the use of dolantin, buprenorphine and procaine administered intravenously as a treatment plan for the abdominal pain resulting from pancreatitis.It is very difficult to control the intractable aching of chronic pancreatitis, but fortunately, it has been reported that buprenorphine is very effective in alleviating the pain that is felt by the patients with chronic pancreatitis.The use of buprenorphine is a simple, safe and effective way compared with current drugs used in treating abdominal ache as a result of pancreatitis.
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