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Updated: Jul 19, 2026
14:56
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Current status of preemptive analgesia
Joel Katz1, Colin J L McCartney
1Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada. jkatz@uhnres.utoronto.ca
Current Opinion in Anaesthesiology
|October 5, 2006
Summary
Preventive analgesia significantly reduces postoperative pain and analgesic needs, unlike preemptive analgesia. Adopting a preventive approach is recommended for better pain management and reduced sensitization.
Area of Science:
- Anesthesiology and Pain Management
- Pharmacology
Background:
- Preemptive analgesia efficacy remains controversial, with conflicting study results.
- Timing of intervention and placebo controls may influence interpretation of preemptive analgesia's clinical utility.
Purpose of the Study:
- To review recent literature on preemptive and preventive analgesia using strict definitions.
- To clarify the benefits of perioperative analgesia by analyzing current evidence.
Main Methods:
- Systematic review of 27 studies published between April 2001 and April 2002.
- Categorization of studies into preemptive (n=12) and preventive (n=15) analgesia.
Main Results:
- Preventive analgesia showed strong evidence of benefit, with 60% of studies reporting reduced pain or analgesic consumption.
- Preemptive analgesia yielded equivocal results, with 41.7% of studies showing greater benefit from preincisional over postincisional treatment.
Conclusions:
- Studies employing a preventive design were more likely to demonstrate positive effects.
- Preventive perioperative analgesia significantly reduces pain beyond the analgesic's duration, especially with N-methyl-D-aspartate antagonists.
- The concept of preventive analgesia should replace preemptive analgesia to focus on minimizing overall postoperative pain and analgesic requirements.
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