Table 2.

Overall recommendations for peri-operative pain management in patients undergoing complex spine surgery

Pre-operative and intra-operative recommendations

Oral or i.v. paracetamol (Grade D)

Oral or i.v. NSAIDs / COX-2 specific inhibitors (Grade A)

i.v. Ketamine infusion (Grade A)

Postoperative recommendations

Epidural analgesia with local anaesthetics and with or without opioids (Grade B)

Oral or i.v. paracetamol (Grade D)

Oral or i.v. NSAIDs/COX-2 specific inhibitors (Grade A)

Opioids as rescue medication (Grade D)

COX, cyclooxygenase; i.v., intravenous.