March 10, 2004

Parenteral vs Epidural Analgesia for Postoperative Pain

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(10):1197-1198. doi:10.1001/jama.291.10.1197

To the Editor: In their meta-analysis, Dr Block and colleagues1 concluded that epidural analgesia provided improved postoperative pain control compared with parenteral opiates, as indicated by a summary difference of 10 mm on a 100-mm visual analogue scale (VAS). We have several concerns about their methods.

First, we question the clinical significance of a 10-mm difference in VAS, especially given the relatively low baseline values of the VAS.

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