Acute Pancreatitis

Many drugs have been tested for specific effect, and none has shown convincing benefit. The main requirements of therapy are:

• To provide adequate analgesia. Opioids are generally satisfactory; their potential disadvantage of contracting the sphincter of Oddi (and retarding the flow of pancreatic secretion) appears to be outweighed by their analgesic efficacy; buprenorphine is often preferred.

• To correct hypovolemia due to the exudation of large amounts of fluid around the inflamed pancreas. Plasma may be required, or blood if the haematocrit falls; in addition large volumes of electrolyte solution may be needed to maintain urine flow.

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