{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T13:05:51Z","timestamp":1776863151152,"version":"3.51.2"},"reference-count":113,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inadequate postoperative pain management after lumbar discectomy may delay recovery, increase the risk of chronic pain, and prolong hospitalization. Effective analgesic strategies must balance pain control with minimal adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the most effective postoperative analgesic interventions for patients undergoing lumbar discectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Databases and Data Treatment<\/jats:title>\n                    <jats:p>This systematic review was preregistered in PROSPERO and conducted in accordance with PRISMA guidelines. Randomized controlled trials were identified through systematic searches in Medline, Embase, and the Cochrane Library. The primary outcome was opioid consumption within 24\u2009h postoperatively. Meta\u2010analyses were conducted using RevMan, with Trial Sequential Analysis (TSA) to adjust for random errors. Risk of bias was assessed using ROB2, and certainty of evidence was evaluated with GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 76 RCTs comprising 5617 participants were included, covering 11 analgesic strategies. Paracetamol, NSAIDs, epidural and intrathecal anaesthetics, local infiltration, nerve blocks, gabapentin, and pregabalin significantly reduced 24\u2010h opioid consumption. Several interventions\u2014including paracetamol, NSAIDs, glucocorticoids, ketamine, epidural and intrathecal anaesthetics, local anaesthetics, nerve blocks, gabapentin, and pregabalin\u2014were also associated with lower pain scores at 6 and 24\u2009h. However, evidence certainty ranged from low to very low due to methodological limitations, small sample sizes, heterogeneity, and inconsistent baseline analgesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multiple analgesic strategies show potential for reducing opioid use and improving early postoperative pain control after lumbar discectomy. Nevertheless, the low certainty of evidence highlights the urgent need for high\u2010quality, standardized trials to inform clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The findings demonstrate that the following analgesics significantly reduce supplemental opioid consumption and pain levels in the immediate postoperative period: PCM, NSAIDs, intrathecal anaesthetics, epidural anaesthetics, LIA\/wound infiltration, nerve blockade, gabapentin, and pregabalin. However, the high risk of bias and low quality of evidence in many of the included trials necessitate cautious interpretation of the findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70261","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T12:11:53Z","timestamp":1775823113000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Pain Management After Lumbar Discectomy. A Systematic Review With Meta\u2010Analyses and Trial Sequential Analyses"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2099-7496","authenticated-orcid":false,"given":"Josephine","family":"Zachodnik","sequence":"first","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"},{"name":"Department of Health Sciences, Faculty of Medicine Lund University  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6000-313X","authenticated-orcid":false,"given":"Rachid","family":"Bech\u2010Azeddine","sequence":"additional","affiliation":[{"name":"Aleris Hospital  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8915-8730","authenticated-orcid":false,"given":"Magnus","family":"Sandberg","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Medicine Lund University  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3878-8612","authenticated-orcid":false,"given":"Rebecca","family":"Scherwin","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-0356","authenticated-orcid":false,"given":"Rikke Malene","family":"Hartvigsen Gr\u00f8nholm Jepsen","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"},{"name":"Department of Clinical Medicine Copenhagen University  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-8586","authenticated-orcid":false,"given":"Louise M\u00f8ller","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Copenhagen University  Copenhagen Denmark"},{"name":"Copenhagen Spine Research Unit (CSRU), Section of Spine Surgery, Center of Rheumatology and Spine Diseases Copenhagen University Hospital  Rigshospitalet Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4727-3132","authenticated-orcid":false,"given":"Kasper H\u00f8jgaard","family":"Thybo","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"},{"name":"Department of Clinical Medicine Copenhagen University  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-2672","authenticated-orcid":false,"given":"Anja","family":"Geisler","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Copenhagen University  Copenhagen Denmark"},{"name":"Department of Digestive Diseases, Transplantation and General Surgery Copenhagen University Hospital  Rigshospitalet Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2003.45.1.62"},{"key":"e_1_2_10_3_1","unstructured":"Al. 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