Medication Prior to Surgery Reduces Pain

The pain that patients experience after prostate cancer operations can be greatly diminished by the administration of anesthetic drugs before surgery, doctors at the University of Pennsylvania Medical Center have reported.

In a study published in the Journal of the American Medical Assn., a team of anesthesiologists and urologists found that the use of preoperative anesthesia, administered through an epidural catheter, stops pain by blocking the natural response of the central nervous system. The effect was evident as long as nine weeks after surgery.

Anesthesiologist Allan Gottschalk and his colleagues studied 90 men in otherwise good health who underwent removal of the prostate for cancer that had not spread beyond the organ.

Patients were randomly assigned to one of three groups. The first received no preoperative painkiller, while patients in the second and third groups received either fentanyl or bupivacaine before surgery. All three groups were given a standard general anesthetic and received similar postoperative drugs for pain.

Gottschalk and his colleagues found significant differences between the groups that received preoperative anesthesia and the group that did not. The two preoperative groups reported 33% less pain during their hospitalization than the group that received pain medication only after surgery.

A telephone survey conducted nine weeks after discharge found that 86% of those who received preoperative painkillers had no pain compared with only 47% of those who received no such medications.