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April 15, 1988

Patient-Controlled Analgesia

JAMA. 1988;259(15):2240. doi:10.1001/jama.1988.03720150022026

To the Editor.  —In the SPECIAL COMMUNICATION by Dr White,1 the following statement was made: "With repeated or continuous administration of narcotic analgesics, tolerance will develop to the desirable (eg, analgesic) and the undesirable (eg, nausea and constipation) pharmacologic effects. As a result, progressively larger narcotic doses may be required to produce the same degree of pain relief during the postoperative period."This statement is not referenced and I do not believe it to be true. It also is not supported by the data shown in Figs 3 and 4 in the article, which show that the total doses of narcotics required tend to decrease in the postoperative period. Could the author please clarify this?