With great anticipation, we read the study by Maheshwari et al. and congratulate the authors for a prominently featured article and infographic on the cover of Anesthesiology. We were interested to see that the results of the study suggest that multimodal analgesia, as administered in this protocol, did not benefit participants’ postoperative quality of recovery, opioid consumption, or pain scores after spine surgery. However, with closer scrutiny, we found several elements of the experimental design that were, perhaps, not well-suited to properly explore the study aim and hypothesis in the context of the primary outcome measure. Surprisingly, the authors did not control for intraoperative analgesic strategies such as surgeon-administered epidural analgesia or local anesthetic wound infiltration. Even more concerning, the authors did not control for postoperative multimodal analgesic medications. Postoperative acetaminophen, gabapentin, tramadol, and ketorolac...

You do not currently have access to this content.