Pain characteristics and multimodal analgesia in children hospitalised with pancreatitis: A retrospective study from a tertiary paediatric centre in India

Background and Aims: The incidence of paediatric pancreatitis is increasing in India and presents significant challenges for clinicians, particularly in managing pain, a hallmark of the condition. Despite this, there is limited literature on pain assessment and analgesic strategies for children with pancreatitis in the Indian context. This study aimed to document pain characteristics and evaluate the effectiveness of analgesic strategies used in hospitalised children with pancreatitis. Methods: A retrospective descriptive cohort study was conducted, including all hospitalised children referred for pain management for pancreatitis between 2020 and 2024 at a tertiary paediatric referral centre. Data collected included pain type, descriptors, pain scales used, timing, location and radiation of pain, associated and relieving factors, and analgesic usage during the first 24–48 hours and until adequate pain control was achieved. Results: Forty patients were included with a mean age of 10.9 years (standard deviation 3.6); 16 were males and 24 females. The mean length of hospital stay was 12.3 days (standard deviation 12.1). Most children reported severe abdominal pain, frequently radiating to the back. Multimodal analgesia was commonly used, including paracetamol, non-steroidal anti-inflammatory drugs, tramadol, gabapentin, and morphine for refractory pain. The mean numerical rating scale scores decreased from 7.43 ± 1.24 at presentation to 1.13 ± 0.64 at 48 hours. Conclusion: Multimodal analgesia effectively controlled pain in children with pancreatitis, with paracetamol, non-steroidal inflammatory drugs, and tramadol forming the cornerstone of therapy. Structured pain assessment and timely escalation of analgesics are essential to improving comfort and clinical outcomes in this population.