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August 12, 1998

Preemptive Analgesia for Prostatectomy—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(6):517-518. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-6-jac057001

In Reply.—Drs Hall and Roehrborn appear to have missed the major point of our article. The goal of our recent study was not to delineate a "critical pathway" for radical retropubic prostatectomy (RRP), nor was it to compare various modalities of acute postoperative pain therapy. Rather, as we clearly stated in the abstract of our article, we wished to "determine the impact of preemptive analgesia on postoperative pain." However, given the large number of RRP procedures performed each year and the many efforts to streamline the surgical care of these patients,1,2 it is not unreasonable that our study be evaluated specifically in terms of its impact on patients presenting for this type of surgery. Toward that end, Hall and Roehrborn express concerns about the impact of epidural anesthesia and analgesia on hospital stay and costs and advocate the use of intravenous ketorolac for postoperative analgesia, although none of the studies they cite quantify postoperative pain.

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