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July 14, 1993


Author Affiliations

Yale University School of Medicine and Yale—New Haven Hospital, New Haven, Conn

JAMA. 1993;270(2):188-190. doi:10.1001/jama.1993.03510020052013

Despite a wealth of information, an abundance of safe, effective drugs, and a variety of delivery systems, medicine in the United States has failed to adequately manage pain. Thus, the protocol for treatment of acute pain, the focus of the first report by the Agency for Health Care Policy and Research, has four goals: (1) to reduce the incidence and severity of acute postoperative and posttraumatic pain, (2) to educate the patient as to the need to communicate unrelieved pain, (3) to enhance patient comfort and satisfaction, and (4) to reduce postoperative complications and reduce hospital stays after surgery.1 The protocol also emphasizes that prevention is better than treatment.

McQuay2 describes preemptive analgesia, an approach to pain management that emphasizes administration of analgesic agents prior to injury. Numerous laboratory studies have demonstrated that noxious stimuli alter neural function and preemptive analgesia prevents or reduces any memory of the