LAUSR

In a single-center, randomized, non-inferiority trial including 80 patients who underwent robot-assisted radical prostatectomy, Lee et al 1 compared clinical efficacy of a non-opioid multimodal analgesia (NOMA) protocol with opioid-based patient-controlled analgesia (PCA). They showed that NOMA protocol was non-inferior to opioid-based PCA regarding postoperative pain control, with faster recovery of bowel function and less postoperative nausea and vomiting. With the development of enhanced recovery after surgery (ERAS) protocols, a shift toward non-opioid or opioid-sparing multimodal postoperative analgesia protocol has become popular. 2 In addition to the limitations described by the authors in the discussion section, however, we had several questions about methodology of this study and wished to get the authors’ responses. First, this study used a single-mode postoperative analgesia strategy in the PCA group, ie, PCA with morphine. In fact, the current ERAS protocols recommend multimodal postoperative analgesia strategies including a package of basic analgesics, such as paracetamol, NSAIDs or cyclooxygenase-2 specific inhibitors, gabapentinoids,