Newly Published
Correspondence  |   January 2020
Prevention and Prediction of Postsurgical Pain: Reply
Author Notes
  • Barts Heart Centre, NIHR Biomedical Research Centre, St. Bartholomew’s Hospital, London, United Kingdom. s.anwar@qmul.ac.uk
  • Accepted for publication December 4, 2019.
    Accepted for publication December 4, 2019.×
Article Information
Correspondence
Correspondence   |   January 2020
Prevention and Prediction of Postsurgical Pain: Reply
Anesthesiology Newly Published on January 24, 2020. doi:https://doi.org/10.1097/ALN.0000000000003152
Anesthesiology Newly Published on January 24, 2020. doi:https://doi.org/10.1097/ALN.0000000000003152
We are grateful for the comments and ideas suggested in response to our clinical trial of perioperative analgesia for cardiac surgery.1 
Acknowledgment is given for the role of anxiety and catastrophization in predicting persistent postsurgical pain, but with some suggestion that intraoperative data may somehow shed further light on this. Our trial corroborates the literature in terms of the link with the former but, without any biologic plausibility for the latter, we saw no reason to collect these data for a pain trial of this nature.
The role of catecholamines in synaptic processing is well established, and the uptake of noradrenaline as well as adrenaline at the synaptic cleft does influence efficiency of nociceptive transmission in preclinical and clinical settings. It is important, however, to separate this from the peripheral infusion of a drug which does not readily cross the blood–brain barrier.2