NOT recommended for radical prostatectomy

Alternative
analgesics: Pre-operative belladonna
and opium suppository, melatonin, amantadine, or clonidine

Not recommended (GoR D) due to limited
procedure-specific evidence

Intra-
and postoperative conventional NSAIDs

Not recommended (GoR B)
based on limited procedure-specific (LoE 2) and strong transferable evidence
from multiple procedures concerning an increased risk of bleeding (LoE 1)

Intra-
or postoperative ketamine

Not recommended for
routine use (GoR D) because of conflicting procedure-specific evidence (LoE
4), despite favourable transferable evidence from more painful surgical
procedures (LoE 1)

Lidocaine
patch

Not recommended (GoR B)
based on limited procedure-specific evidence

IM
strong opioids

Not recommended because of
the pain associated with these injections (GoR D)

Transdermal
nicotine and intravenous magnesium

Not recommended (GoR D)
due to limited procedure-specific and transferable evidence

Epidural
analgesia

Not recommended for
prostatectomy (GoR D) despite some procedure-specific evidence (LoE 1) of
analgesic benefit, due to adverse risk:benefit profile

Paravertebral
analgesia

Not recommended (GoR D)
due to limited procedure-specific evidence

TAP-blocks

Not recommended (GoR D)
due to lack of procedure-specific and limited transferable evidence

Intrathecal
opioid anaesthesia and analgesia

Not recommended (GoR B)
despite procedure-specific evidence (LoE 1) of analgesic benefit, due to
adverse risk:benefit profile (intrathecal anaesthesia is also not
recommended). This statement is supported by transferable evidence (LoE 1)
from patients undergoing major surgery

Continuous
local anaesthetic wound infusion

Not recommended (GoR B)
based on procedure-specific evidence (LoE 2) showing lack of analgesic
efficacy

Magnesium
sulfate wound infiltration

Not recommended (GoR D)
due to limited procedure-specific evidence