Surgical Endoscopy

, Volume 21, Issue 7, pp 1047–1053 | Cite as

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

  • E. A. M. NeugebauerEmail author
  • R. C. Wilkinson
  • H. Kehlet
  • S. A. Schug
  • on behalf of the PROSPECT Working Group



Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at


The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT.


To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy.


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.

Key words

Postoperative pain Evidence-based medicine 



The authors acknowledge with gratitude the PROSPECT Working Group for its members’ involvement in discussions regarding the development and implementation of the refined methodology for PROSPECT reviews.

PROSPECT is supported by Pfizer Inc., New York, NY, USA. This paper makes no specific recommendations about the use of any medical products, drugs, or equipment manufactured by Pfizer Inc. or by any of its subsidiaries.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • E. A. M. Neugebauer
    • 1
    Email author
  • R. C. Wilkinson
    • 2
  • H. Kehlet
    • 3
  • S. A. Schug
    • 4
  • on behalf of the PROSPECT Working Group
  1. 1.Institute for Research in Operative MedicineUniversity of Witten/HerdeckeCologneGermany
  2. 2.Choice Medical CommunicationsHitchinEngland
  3. 3.Section for Surgical Pathophysiology 4074The Juliane Marie CentreBlegdamsvej 9Denmark
  4. 4.UWA Anaesthesia, School of Medicine and PharmacologyUniversity of Western Australia PerthWestern Australia

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