Preemptive epidural analgesia and recovery from radical prostatectomy: a randomized controlled trial.

@article{Gottschalk1998PreemptiveEA,
  title={Preemptive epidural analgesia and recovery from radical prostatectomy: a randomized controlled trial.},
  author={Allan Gottschalk and Deborah S. Smith and David R Jobes and Sean K. Kennedy and Sara E. Lally and Vicki E. Noble and Kathy F. Grugan and Harry A. Seifert and Albert T. Cheung and Stanley B. Malkowicz and Brett B. Gutsche and Alan J. Wein},
  journal={JAMA},
  year={1998},
  volume={279 14},
  pages={
          1076-82
        }
}
CONTEXT Preemptive analgesia can decrease the sensitization of the central nervous system that would ordinarily amplify subsequent nociceptive input, but a clear demonstration of its clinical efficacy is necessary for it to become a routine component of acute pain therapy. OBJECTIVE To determine the impact of preemptive epidural analgesia on postoperative pain and other clinically important outcome variables after radical retropubic prostatectomy. DESIGN AND SETTING A block randomized… Expand
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Postoperative Morphine Use and Hyperalgesia Are Reduced by Preoperative but Not Intraoperative Epidural Analgesia: Implications for Preemptive Analgesia and the Prevention of Central Sensitization
TLDR
Preincisional administration of epidural lidocaine and fentanyl was associated with a significantly lower rate of morphine use, lower cumulative morphine consumption, and reduced hyperalgesia compared with a sham epidural condition, highlighting the importance of including a standard treatment control group. Expand
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TLDR
Whereas preemptive epidural analgesia resulted in consistent improvements in all three outcome variables, preemptive local anesthetic wound infiltration and NSAID administration improved analgesic consumption and time to first rescue analgesic request, but not postoperative pain scores. Expand
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Lower postoperative analgesic requirements in the EA group, when compared with both the EG and GA groups, indicate that: (1) EA patients had less postoperative pain, and (2) an efficient intraoperative blockade of noxious afferent signals to the central nervous system is fundamental in reducing postoperativePain. Expand
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The hypothesis that patients receiving epidural fentanyl before incision would have less pain and need fewer analgesics post-operatively than patients receiving the same dose of epiduralentanyl after incision was tested. Expand
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