After careful patient selection, cyclooxygenase inhibitors may be considered in the perioperative period to reduce postoperative pain. (B-R, Class IIb)

The routine administration of perioperative acetaminophen for postoperative pain as a part of a multimodal analgesia regimen is not well-established. (B-NR, Class IIb)

To reduce opioid consumption in the immediate postoperative period and considering the potential for long-lasting analgesic effects, an infusion of ketamine in the perioperative period (initiated in the intraoperative period and continued into the postoperative period) may be reasonable. (B-R, Class IIb)

The usefulness of routine use of perioperative gabapentinoids in multimodal analgesic regimen is not well-established. (B-R, Class III)

A multimodal approach to PONV prophylaxis is indicated in all patients undergoing complex spine surgeries. (B-R, Class I)

Preoperative and intraoperative factors may be considered when planning patient admission to the ICU or floor/ward. (B-NR, Class IIb)

We suggest to avoid hypotensive episodes (MaP lower than 65 mmHg). (2C)

We suggest to continuously monitor aP (inva-sive and not invasive) as a more reliable method to identify even short periods of hemodynamic instability and hypotension. (2C)

We suggest adoption of invasive aP monitoring in high risk patients with the aim of obtaining oxymetric (arterial oxygen pressure and saturation, and hemoglobin) and metabolic (lactacidemia) parameters. (2C)

In paediatric patients, analgesics are administered at equal intervals according to age-related pharmacokinetics of drugs, or in continuous infusions, which allows a constant blood concentration of analgesics to be maintained and effective analgesia to be provided. (1C)