ESRA Updates

May 2020 | Issue 02


Marc Van de Velde (Chair of PROSPECT, UZ Leuven, Belgium) @MarcVandeVelde6


Effective analgesia is essential for optimal patient recovery after surgery (Joshi et al 2014; Lee et al 2018) but postoperative pain continues to be poorly managed in clinical practice (Gan et al 2014; Gerbershagen et al 2013). The PROSPECT initiative aims to provide healthcare professionals with practical recommendations for pain management in common but potentially painful operations.

PROSPECT recommendations for each intervention are formulated after careful evaluation of:

  • Procedure-specific evidence, based on a systematic review of the literature
  • The risks and benefits of the intervention in the specific surgical setting
  • Use of the intervention in the context of multimodal, non-opioid analgesic strategies and modern peri-operative care pathways.

The PROSPECT website ( offers:

  • Accessible, practical and pragmatic advice on peri-operative pain management
  • Evidence-based arguments for and against the use of analgesic interventions
  • Translations of the summary recommendations in six languages.
  • Links to all the PROSPECT publications (most are open access)

Recent PROSPECT publications and recommendations:

  • Just Released! Oncological breast surgery: Jacobs A, et al. Anaesthesia 2020; 26 January.
  • Rotator cuff repair surgery: Toma O, et al. Anaesthesia. 2019;74:1320–1331.
  • Laparoscopic sleeve gastrectomy: Macfater H, et al. World J Surg. 2019;43(6):1571–1580.
  • Haemorrhoidectomy: Sammour T, et al. World J Surg. 2017;41(2):603–614.
  • Laparoscopic hysterectomy: Lirk P, et al. Reg Anesth Pain Med 2019;44(4):425–436 and a 2020 literature update
  • Laparoscopic cholecystectomy: Barazanchi AWH, et al. Br J Anaesth. 2018;121(4):787–803.
  • PROSPECT methodology: Joshi GP, et al. Anaesthesia 2019;74:1298–1304.
  • The PROSPECT initiative: Beloeil H, et al. Anaesth Crit Care Pain Med. 2018;37(4):305–306; Lee B, et al. Best Pract Res Clin Anaesthesiol. 2018;32(2):101–111.


Coming soon in 2020!

New procedures Updates
Tonsillectomy Open abdominal hysterectomy
Complex back surgery Hernia repair
Laminectomy C-section
Bunionectomy Total hip arthroplasty
Hepatectomy Total knee arthroplasty


Also underway: Prostatectomy, Craniotomy, Open Heart Surgery, Appendectomy, Oesophagectomy, Hip fracture, VATS, Open thoracotomy update

PROSPECT is supported by an unrestricted grant from the European Society of Regional Anaesthesia and Pain Therapy (ESRA).

Topics: Guidelines , PROSPECT , Procedure Specific Evidence , Postoperative Acute Pain , Recommendations

ASRA-PM and ESRA's Path to Collective Success

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