A critical approach to research on perioperative pain management

Joshi, Girish P.; Beloeil, Helene; Lobo, Dileep N.; Pogatzki-Zahn, Esther M.; Sauter, Axel R.; Van De Velde, Marc; Wu, Christopher L.; Kehlet, Henrik

Abstract

Optimal postoperative pain management is a prerequisite for enhancing functional recovery after surgery. However, many studies assessing analgesic interventions have limitations. Consequently, further improvements in study design are urgently needed. In this focused editorial, we critically review prevalent trial designs and outcome measures including treatment-related adverse events evaluating analgesic interventions. Novel clinical trial designs should improve efficiency and enhance the likelihood of detecting relevant treatment effects. Also, cohort and database studies using propensity score matching and directed acyclic graphs may provide “real-world” generalisable information. Procedure-specific and patient-specific trials should allow identification of sub-populations most likely to benefit from a particular intervention after a specific surgical procedure, and thus ascertain optimal analgesic strategies in challenging populations.

Citation

Joshi, G. P., Beloeil, H., Lobo, D. N., Pogatzki-Zahn, E. M., Sauter, A. R., Van De Velde, M., Wu, C. L., & Kehlet, H. (2024). A critical approach to research on perioperative pain management. British Journal of Anaesthesia, https://doi.org/10.1016/j.bja.2024.11.004

• Journal Article Type: Article
• Acceptance Date: Nov 5, 2024
• Online Publication Date: Nov 28, 2024
• Publication Date: Nov 28, 2024
• Deposit Date: Nov 6, 2024
• Publicly Available Date: Nov 29, 2025
• Journal: British Journal of Anaesthesia
• Print ISSN: 0007-0912
• Electronic ISSN: 1471-6771
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.bja.2024.11.004
• Keywords: perioperative pain; research; analgesics; study design; trials; evidence base
• Public URL: https://nottingham-repository.worktribe.com/output/41549124
• Publisher URL: https://www.bjanaesthesia.org/article/S0007-0912(24)00661-5/abstract