Preemptive analgesia: problems with assessment of clinical significance.

Abstract

The results of clinical studies on the value of preemptive analgesia are far from being unanimous. There are a number of potential problems related to preemptive analgesia that could lead to controversy regarding its clinical significance. The following potential problems are analyzed: (1) terminology, (2) approach to reveal the effect of preemptive analgesia, (3) verification of the direct pharmacological effect of a treatment, (4) partial preemptive effect in control, (5) intensity of noxious stimuli, (6) difference in a drug concentration between study groups during postoperative period, and (7) outcome measures.