**1. Introduction**

Acute pancreatitis (AP) is an acute inflammatory disorder of the pancreas with a complex and variable course. Most patients develop only mild to moderate disease meaning no or just transient organ failure during the first 48 hours after the onset, but about 20–30% develops a severe form with local complications such as necrosis and often associated with single or multiple organs dysfunction and necessity of intensive care unit (ICU) admission. Severe AP is associated with persistent hemodynamic instability, respiratory distress with mechanical ventilation requirement, kidney failure, and is burdened by high mortality. ICU patients are often sedated and receive careful pain management, as well as careful hydration control [1, 2].

Patients with AP typically present with acute abdominal pain and significant depletion of intravascular volume. The main goal of initial treatment is to alleviate symptoms and prevent complications [3]. Fluid management and pain control are two central aspects of multidisciplinary care of AP, seem to impact on evolution, and influence the outcome. Management in the early hours gives the impression to be very important, when patients are usually assessed and assisted in the emergency department or general surgical ward.

Most patients have a self-limiting disease that resolves with supportive measures, and clinical choices can adjust the course of disease, reduce the hospitalization and health costs [4, 5].

Early intravenous volume resuscitation reduces pancreatic hypoperfusion and multiorgan failure, but fluid overload has been associated with worse outcome, and maintaining proper hydration could be challenging.

Pain relief has a positive impact because of reduced stress response, sympatheticinduced vasoconstriction, and pulmonary complications. A modern and effective multimodal analgesic approach aims to achieve patient's satisfaction and minimize side effects.

AP can evolve and worsen so it is required to routinely reassess the clinical parameters and personalize the fluidic and analgesic therapy [6].

There is evidence that the incidence of AP has been rising in recent years, probably due to the increase in the average age, obesity, and some drug therapy for chronic disease treatment too. As a result, they are patients with significant comorbidities that require a considerable health effort, which may involve several healthcare professionals.

This is why multidisciplinary management could be helpful, with the purpose of improving patient's outcome and hospital stay.
