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

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Abstract

Background

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 http://www.postoppain.org

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

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.

Author information

Authors and Affiliations

  1. Institute for Research in Operative Medicine, University of Witten/Herdecke, Ostmerheimer Strasse 200, D-51109, Cologne, Germany

    E. A. M. Neugebauer

  2. Choice Medical Communications, Hitchin, England

    R. C. Wilkinson

  3. Section for Surgical Pathophysiology 4074, The Juliane Marie Centre, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark

    H. Kehlet

  4. UWA Anaesthesia, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia

    S. A. Schug

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  1. E. A. M. Neugebauer
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  3. H. Kehlet
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  4. S. A. Schug
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on behalf of the PROSPECT Working Group

Corresponding author

Correspondence to E. A. M. Neugebauer.

Additional information

PROSPECT Working Group: Edmund A. M. Neugebauer, Surgeon, Cologne, Germany; Henrik Kehlet, Surgeon, Copenhagen, Denmark; Stephan A. Schug, Anaesthesiologist, Perth, Western Australia; Francis Bonnet, Anaesthesiologist, Paris, France; Frederic Camu, Anaesthesiologist, Brussels, Belgium; Barrie J. Fischer, Anaesthesiologist, Worcestershire, UK; Girish Joshi, Anaesthesiologist, Texas, USA; H. Rory F. McCloy, Surgeon, Manchester, UK; Narinder Rawal, Anaesthesiologist, Örebro, Sweden; Christian J. P. Simanski, Surgeon, Cologne, Germany

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Neugebauer, E.A.M., Wilkinson, R.C., Kehlet, H. et al. PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain. Surg Endosc 21, 1047–1053 (2007). https://doi.org/10.1007/s00464-006-9186-4

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  • DOI: https://doi.org/10.1007/s00464-006-9186-4

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