{
  "abstract": "Introduction: 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.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedics, Paras HMRI Hospital, Patna, Bihar, India.",
    "Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.",
    "Department of Anaesthesia, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Janki Sharan Bhadani",
      "orcid": "0000-0002-3329-8355"
    },
    {
      "affs": [
        1
      ],
      "name": "Indrajeet Kumar",
      "orcid": "0000-0002-4821-3684"
    },
    {
      "affs": [
        2
      ],
      "name": "Priyanka Kumari",
      "orcid": "0009-0008-1456-5420"
    },
    {
      "affs": [
        2
      ],
      "name": "Akhileshwar"
    },
    {
      "affs": [
        1
      ],
      "name": "Nishant Kashyap"
    },
    {
      "affs": [
        1
      ],
      "name": "Santosh Kumar"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2c7sdr054sfqx.bib",
  "cited_by": 0,
  "doi": "10.13107/jocr.2026.v16.i11.8558",
  "fulltext_url": "https://europepmc.org/articles/PMC13741001",
  "id": "2c7sdr054sfqx",
  "issns": [
    "2250-0685",
    "2321-3817"
  ],
  "landing_url": "https://europepmc.org/article/MED/42997146",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2703|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7225584003",
  "pdf_url": "https://europepmc.org/articles/PMC13741001?pdf=render",
  "pmcid": "PMC13741001",
  "pmid": "42997146",
  "published": "2026-11-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2c7sdr054sfqx.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42997146",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42997146"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2703|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Pain Management in Orthopedic Surgery: A Procedure-Specific Orthopedic-Anesthesia Approach to Perioperative Analgesia.",
  "title_text": "Pain Management in Orthopedic Surgery: A Procedure-Specific Orthopedic-Anesthesia Approach to Perioperative Analgesia.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/2c7sdr054sfqx",
  "venue": "Journal of orthopaedic case reports",
  "versions": []
}