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. Cohort and database studies using propensity score matching and directed acyclic graphs could provide real-world generalisable information. Procedure-specific and patient-specific trials should allow identification of subpopulations most likely to benefit from a particular intervention after a specific surgical procedure and thus ascertain optimal analgesic strategies in challenging populations.

中文翻译：

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围手术期疼痛管理研究的关键方法。


最佳的术后疼痛管理是增强术后功能恢复的先决条件。然而，许多评估镇痛干预的研究存在局限性。因此，迫切需要进一步改进研究设计。在这篇重点突出的社论中，我们批判性地回顾了流行的试验设计和结果测量，包括评估镇痛干预的治疗相关不良事件。新颖的临床试验设计应提高效率并增加检测相关治疗效果的可能性。使用倾向得分匹配和有向无环图的队列和数据库研究可以提供真实世界的可推广信息。手术特异性和患者特异性试验应允许确定最有可能从特定外科手术后的特定干预中受益的亚群，从而确定具有挑战性的人群的最佳镇痛策略。