Intravenous methocarbamol for acute pain after spine surgery: a target trial emulation
Main finding · Time-weighted average pain scoreResult — go to the resultAdjusted mean difference 0.1 95% CI −0.1 to 0.4Authors' conclusion
In this emulated target trial of elective spine surgery, intravenous methocarbamol did not reduce acute postoperative pain or opioid consumption.
Study context
- Population
- Patients undergoing elective spine surgery (posterior spinal fusion, anterior cervical discectomy and fusion, laminectomy/laminotomy), January 1, 2020 to December 31, 2023matched cohort
- Participants
- 1,270 patients
- Exposure
- Methocarbamol vs Usual care
- Outcome
- Time-weighted average pain score
- Follow-up
- 6-hour window after treatment assignment
Methodological detailsretrospective cohort study using electronic health record data, 1:1 time-varying propensity-score matched
- Retrospective cohort study using electronic health record data
- 1:1 time-varying propensity-score matched
Main finding
As reported in the abstract
6 hours
Adjusted mean difference
0.1
95% CI −0.1 to 0.4
Methocarbamol vs Usual care
adjusted mean difference 0.1 (95% CI −0.1 to 0.4)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted mean difference (OME) (95% CI) | |
|---|---|---|
| Cumulative opioid use (OME) · 6 hours | 0.6 (−1.4 to 2.5) | |
| −2−10123Difference, OME (linear scale) |
| Outcome | Adjusted mean difference (95% CI) | |
|---|---|---|
| Pain scores, marginal structural model (sensitivity analysis)Slightly increased, not clinically meaningful | 0.5 (0.3–0.7) | |
| −0.500.51Difference (linear scale) |
Pain scores, marginal structural model (sensitivity analysis)
- Other sensitivity analyses generally confirmed primary results
Original publication
Intravenous methocarbamol for acute pain after spine surgery: a target trial emulation. Reg Anesth Pain Med. Published 8 September 2025. doi:10.
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