急性胰腺炎（AP）患者常以明显腹痛起病，及时、充分的镇痛是早期治疗的重要环节。临床上阿片类药物常用于疼痛控制，但也需要关注恶心呕吐、肠道功能、呼吸抑制和用药安全等问题。非甾体抗炎药（NSAIDs）作为非阿片镇痛选择，能否在控制疼痛的同时保持相近安全性，仍需要随机对照试验证据回答。成人急性胰腺炎早期镇痛，非阿片方案会比阿片类药物更合适吗？
下面这篇文献将回答这个问题。
文献英文标题
Early Analgesia for the Management of Acute Pancreatitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials
英文摘要要点
Methods:
A systematic literature search was conducted across PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, and ClinicalTrials.gov from database/registry inception to December 2025 to obtain relevant data. Randomized controlled trials involving adults aged ≥18 years diagnosed with AP, irrespective of the etiology and severity, who were administered analgesics (opioids, non-steroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, epidural anesthesia, local anesthesia, and paracetamol) and compared with placebo, conventional treatment, or another analgesic modality were included in this review. The primary outcome assessed was pain reduction. The secondary outcomes assessed were the need for rescue analgesia, length of hospital stay, complications (local and/or systemic), mortality, and adverse drug effects. Risk of bias was assessed using the Cochrane Risk of Bias tool 2.0. Effect estimates were pooled using a random-effects meta-analysis (DerSimonian-Laird approach), while non-pooled outcomes were summarized narratively.
Results:
A total of 13 studies were included in the analysis. NSAIDs provided pain relief comparable to opioids, with a lower incidence of local complications (RR: 0.59, 95% CI: 0.37-0.94). No significant differences in the need for rescue analgesia (OR: 0.88, 95% CI: 0.33-2.35), length of hospital stay (MD: -2.68 days, 95% CI: -6.27-0.91), mortality (RR: 0.76, 95% CI: 0.19-3.05), and adverse drug effects (RR: 0.55, 95% CI: 0.17-1.76) were observed. However, the findings are limited by study bias and he...