Pain Management in Orthopedic Surgery: A Procedure-Specific Orthopedic-Anesthesia Approach to Perioperative Analgesia.
Year: 2026
Type: article
Abstract: Post-operative pain in orthopedic surgery is clinically important because inadequate analgesia can impair mobilization, sleep, physiotherapy and discharge, while excessive analgesia can cause sedation, motor weakness, drug toxicity and unnecessary opioid exposure. This narrative review uses a structured literature search of PubMed/MEDLINE and targeted review of recent systematic reviews, randomized trials, consensus statements and procedure-specific recommendations, with emphasis on publications available through September 2026. Evidence is synthesized qualitatively according to procedure, analgesic strategy, functional outcomes, and limitations of the underlying evidence. Present evidence supports multimodal analgesia, but does not support a universal regimen or routine addition of every available intervention. Regional techniques can improve early analgesia, although benefits vary by procedure and may be offset by motor block, rebound pain, or limitations in post-operative examination. A non-steroidal anti-inflammatory drugs (NSAIDs) provide opioid-sparing analgesia, but the relationship between NSAID exposure and fracture healing remains uncertain and appears to depend on drug, dose, duration, fracture type, and patient factors. Opioids remain appropriate as rescue therapy when clinically indicated. Persistent post-surgical pain is influenced by pre-operative and biopsychosocial factors and acute analgesia has not been shown consistently to prevent it. The practical framework proposed here therefore links the operation, patient risk profile, analgesic options, and rehabilitation task, with unexpected severe pain treated as a trigger for clinical reassessment rather than automatic escalation.
Source: PubMed
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225584003
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