Skip to main content

Preemptive Analgesia: Problems with Assessment of Clinical Significance

  • Protocol
  • First Online:
Analgesia

Part of the book series: Methods in Molecular Biology ((MIMB,volume 617))

Abstract

The results of clinical studies on the value of preemptive analgesia are far from being unanimous. There are a number of potential problems related to preemptive analgesia that could lead to controversy regarding its clinical significance. The following potential problems are analyzed: (1) terminology, (2) approach to reveal the effect of preemptive analgesia, (3) verification of the direct pharmacological effect of a treatment, (4) partial preemptive effect in control, (5) intensity of noxious stimuli, (6) difference in a drug concentration between study groups during postoperative period, and (7) outcome measures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Protocol
USD 49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Crile GW (1913) The kinetic theory of shock and its prevention through anoci-association. Lancet 185:7–16

    Article  Google Scholar 

  2. Woolf CJ (1983) Evidence for a central component of postinjury pain hypersensitivity. Nature 308:686–688

    Article  Google Scholar 

  3. Wall PD (1988) The prevention of postoperative pain. Pain 33:289–290

    Article  PubMed  CAS  Google Scholar 

  4. Kissin I (2000) Preemptive analgesia. Anesthesiology 93:1138–1143

    Article  PubMed  CAS  Google Scholar 

  5. Kissin I (1994) Preemptive analgesia: terminology and clinical relevance. Anesth Analg 79:809–810

    PubMed  CAS  Google Scholar 

  6. Katz J (2003) Timing of treatment and preemptive analgesia. In: Rowbotham DJ, Macintyre PE (eds) Acute pain. Arnold, London, pp 113–162

    Google Scholar 

  7. Moiniche S, Kehlet H, Dahl JB (2002) A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief. Anesthesiology 96:725–741

    Article  PubMed  Google Scholar 

  8. Tverskoy M, Cozacov C, Ayache M, Bradley EL, Kissin I (1990) Postoperative pain after inguinal herniorrhaphy with different types of anesthesia. Anesth Analg 70:29–35

    Article  PubMed  CAS  Google Scholar 

  9. McQuay HJ (1992) Pre-emptive analgesia. Br J Anaesth 69:1–3

    Article  PubMed  CAS  Google Scholar 

  10. Ong KS, Lirk P, Seymour RA (2005) The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg 100:757–773

    Article  PubMed  Google Scholar 

  11. Shir Y, Raja SN, Frank SM (1994) The effect of epidural versus general anesthesia on postoperative pain and analgesia requirements in patients undergoing radical prostatectomy. Anesthesiology 80:49–56

    Article  PubMed  CAS  Google Scholar 

  12. Gottschalk A, Smith DS, Jobes DR, Kennedy SK, Lally SE, Noble VE, Grugan KF, Seifert HA, Cheung A (1998) Preemptive epidural analgesia and recovery from radical prostatectomy: a randomized controlled trial. JAMA 279:1076–1082

    Article  PubMed  CAS  Google Scholar 

  13. Moller IW, Hjortso E, Kratz T, Wandall E, Kehlet H (1984) The modifying effect of spinal anesthesia in intra- and postoperative adrenocortical and hyperglycemic response to surgery. Acta Anaesthesiol Scan 28:266–269

    Article  CAS  Google Scholar 

  14. Moller IW, Rem J, Brandt MR, Kehlet H (1982) Effect of posttraumatic epidural analgesia on the cortisol and hyperglycemic response to surgery. Acta Anaesthesiol Scand 26:56–58

    Article  PubMed  CAS  Google Scholar 

  15. Goto T, Marota JJA, Crosby G (1994) Nitrous oxide induces preemptive analgesia in the rat that is antagoinized by halothane. Anesthesiology 80:409–416

    Article  PubMed  CAS  Google Scholar 

  16. O’Connor TC, Abram SE (1995) Inhibitin of nociception-induced spinal sensitization by anesthetic agents. Anesthesiology 82:259–266

    Article  PubMed  Google Scholar 

  17. Jebeles JA, Reilly JS, Gutierrez JF, Bradley EL, Kissin I (1991) The effect of pre-incisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anesthesia. Pain 47:305–308

    Article  PubMed  CAS  Google Scholar 

  18. Norman PH, Daley MD, Lindsey RW (2001) Preemptive analgesic effects of ketorolac in ankle fracture surgery. Anesthesiology 94:599–603

    Article  PubMed  CAS  Google Scholar 

  19. Tverskoy M, Oz Y, Isakson A, Finger J, Bradley EL, Kissin I (1994) Preemptive effect of fentanyl and ketamine on postoperative pain and wound hyperalgeisa. Anesth Analg 78:205–210

    Article  PubMed  CAS  Google Scholar 

  20. Austin KL, Stapleton JV, Mather LE (1980) Relationship between blood meperidine concentrations and analgesic response: A preliminary report. Anesthesiology 53:460–466

    Article  PubMed  CAS  Google Scholar 

  21. Jamison RN, Taft K, O’Hara JP, Ferrante FM (1993) Psychosocial and pharmacologic predictors of satisfaction with intravenous patient-controlled analgesia. Anesth Analg 77:121–125

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Igor Kissin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this protocol

Cite this protocol

Kissin, I. (2010). Preemptive Analgesia: Problems with Assessment of Clinical Significance. In: Szallasi, A. (eds) Analgesia. Methods in Molecular Biology, vol 617. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-323-7_34

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-323-7_34

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-322-0

  • Online ISBN: 978-1-60327-323-7

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics