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The aim of this review was to evaluate the available literature and develop recommendations for optimal pain management after one- or two-level lumbar laminectomy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A systematic review utilizing the PROcedure-SPECific Post-operative Pain ManagemenT (PROSPECT) methodology was undertaken. Randomised controlled trials (RCTs) published in the English language from 1 January 2008 until 31 March 2020\u2014assessing post-operative pain using analgesic, anaesthetic and surgical interventions\u2014were identified from MEDLINE, EMBASE and Cochrane Databases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Out of 65 eligible studies identified, 39 RCTs met the inclusion criteria. The analgesic regimen for lumbar laminectomy should include paracetamol and a non-steroidal anti-inflammatory drug (NSAID) or cyclooxygenase (COX)\u20142 selective inhibitor administered preoperatively or intraoperatively and continued post-operatively, with post-operative opioids for rescue analgesia. In addition, surgical wound instillation or infiltration with local anaesthetics prior to wound closure is recommended. Some interventions\u2014gabapentinoids and intrathecal opioid administration\u2014although effective, carry significant risks and consequently were omitted from the recommendations. Other interventions were also not recommended because there was insufficient, inconsistent or lack of evidence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Perioperative pain management for lumbar laminectomy should include paracetamol and NSAID- or COX-2-specific inhibitor, continued into the post-operative period, as well as intraoperative surgical wound instillation or infiltration. Opioids should be used as rescue medication post-operatively. Future studies are necessary to evaluate the efficacy of our recommendations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-020-06661-8","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T18:03:11Z","timestamp":1606500191000},"page":"2925-2935","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Pain management after laminectomy: a systematic review and procedure-specific post-operative pain management (prospect) recommendations"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7881-9791","authenticated-orcid":false,"given":"Laurens","family":"Peene","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Le Cacheux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel R.","family":"Sauter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish P.","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Beloeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PROSPECT Working Group Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"European Society of Regional Anaesthesia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"key":"6661_CR1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000990","author":"A Elsharydah","year":"2020","unstructured":"Elsharydah A, Duncan KL, Rosero EB et al (2020) Readmission rate after 2-level lumbar decompression: a propensity-matched cohort study comparing inpatient and outpatient settings. 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Girish P. Joshi has received honoraria from Baxter and Pacira Pharmaceuticals. Francis Bonnet has received honoraria from Pfizer, The Medicine Company, Abbott France and Nordic Pharma France. Henrik Kehlet has received honoraria from Pfizer and Grunenthal. The Anesthesiology Unit of the University of Western Australia, but not Stephan Schug privately, has received research and travel funding and speaking and consulting honoraria from bioCSL, Eli Lilly, Indivior, iX Biopharma and Pfizer. Narinder Rawal has received honoraria from Baxter and Sintetica. Marc Van de Velde received honoraria from Sintetica, Grunenthal, Vifor Pharma, MSD, Nordic Pharma, Janssen Pharmaceuticals, Heron Therapeutics and Aquettant. H\u00e9l\u00e8ne Beloeil has received honoraria from Orion, Abbvie and Aspen.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}