To the Editor:--In a letter to the editor, [1]Ready attempted to define which health-care providers are managing patient-controlled analgesia (PCA). He reports that 73% of responding institutions have an anesthesiology-based acute pain service (APS). However, the data are misleading. Table 1 indicates that 236 institutions have an anesthesia-based APS, whereas Table 2 lists 221 institutions with anesthesiologists participating in the management of PCA. Additionally, based on Table 2, the number of institutions indicating their participation in PCA is greater than the number of institutions responding to the survey. From this, we infer that there is an overlap of the groups participating in the management of PCA. However, it is unclear which groups overlap and which have primary responsibility for PCA management. Those with the responsibility will determine the quality of care and ultimately, perhaps, patient outcome.

Sandra R. Weitz, M.D., Director, Acute Pain Service, Department of Anesthesia, S-436, University of California, San Francisco, 521 Parnassus Avenue, San Francisco, California 94143-0648.

(Accepted for publication May 27, 1995.)

1.
Ready LB: How many acute pain services are there in the United States, and who is managing patient-controlled analgesia? (letter). ANESTHESIOLOGY 82:322, 1995.