PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain

Neugebauer, Edmund; Wilkinson, Roseanne C.; Kehlet, Henrik; Schug, Stephan A.

doi:10.1007/s00464-006-9186-4

Cited by 47 publications

(48 citation statements)

References 36 publications

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“…Such a program permitted a more rapid postoperative return of normal cardiopulmonary response to treadmill exercise and facilitated return of overall exercise capacity 6 weeks after surgery (Basse It can be seen from the foregoing that a multi-interventional and rehabilitation strategy is required, including very effective pain relief, if optimal outcomes are to be achieved, as outlined in procedure-specific recommendations from the PROSPECT group (Kehlet et al, 2007). Postoperative rehabilitation should include pharmacological, physical, psychological and nutritional components (Figure 1.4).…”

Section: Pain and Analgesia: Effects On Injury-induced Organ Dysfunctionmentioning

confidence: 99%

“…Several randomised controlled studies have shown that the addition of glucocorticoids reduces postoperative pain and analgesic requirement (see below). Additional benefits include decreased PONV and fatigue (Romundstad et al, 2006;Kehlet, 2007).…”

Section: Glucocorticoidsmentioning

confidence: 99%

“…However more information is still needed about dose-finding, the effects of repeat dosing, procedure-specific effectiveness and safety (Kehlet, 2007). While good data regarding side effects are still lacking, high doses have been used in elective and emergency surgical patients without an increase in morbidity (Sauerland et al, 2000 Level I).…”

Section: Glucocorticoidsmentioning

confidence: 99%

“…Earlier studies have shown benefit after oral surgery, tonsillectomy, lumbar disc surgery, laparoscopic cholecystectomy, arthroscopic surgery and lung resection (Gilron, 2004;Kehlet, 2007).…”

Section: Glucocorticoidsmentioning

confidence: 99%

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Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Pain and Analgesia: Effects On Injury-induced Organ Dysfunctionmentioning

confidence: 99%

Section: Glucocorticoidsmentioning

confidence: 99%

Section: Glucocorticoidsmentioning

confidence: 99%

Section: Glucocorticoidsmentioning

confidence: 99%

See 2 more Smart Citations

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…Maternal satisfaction from this protocol and the use of rectal analgesia has not been previously studied. Also, the use of opioids is associated with side effects such as nausea, vomiting, confusion, constipation, tolerance and physical dependency 9,10,11 .…”

Section: Introductionmentioning

confidence: 99%

Rectal Versus Intramuscular Diclofenac Sodium for Pain Relief Following Caesarean Section: A Randomised Controlled Trial

Adebayo¹

2018

jmscr

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Evidence-based management of pain after haemorrhoidectomy surgery

Joshi

Neugebauer

2010

British Journal of Surgery

102

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PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain

Abstract: Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.

Cited by 47 publications

References 36 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Rectal Versus Intramuscular Diclofenac Sodium for Pain Relief Following Caesarean Section: A Randomised Controlled Trial

Evidence-based management of pain after haemorrhoidectomy surgery

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