Perioperative Analgesic Interventions and Strategies for Pain Management After Major Orthopedic and Spine Surgery: A Systematic Review

Background/Objectives: Postoperative pain remains a major clinical and public health challenge, contributing to delayed recovery, increased opioid use, and risk of chronic postsurgical pain. A variety of postoperative analgesic interventions and strategies, including multimodal analgesia, regional anesthesia, local analgesic techniques, adjunctive pharmacological agents and structured perioperative care pathways have been proposed to improve pain management and reduce opioid exposure. This systematic review evaluated the effectiveness of perioperative analgesic interventions and strategies in major orthopedic and spine surgeries.

Methods

The study was registered in PROSPERO and followed the PRISMA guidelines. A comprehensive search was performed to identify controlled trials involving major surgeries. Risk of bias was assessed using Cochrane tools, and the certainty of evidence was evaluated using the GRADE approach.