Searching for articles
The search started by looking at the bibliographies of research articles used in the previous discussion. However, most of the articles found were published before the year 2015, meeting the exclusion criteria. The next step was the search for non-research articles on Google. The search was rather specific as it involved typing the PICO question on the search bar. But none of the articles found made it to the final list; they were excluded for mainly being secondary research. The next step was a systematic search of PubMed and CINHAL. The search terms and MESH terms used Pain management, pharmacological, non-opioid, opioid, orthopedic patients, multimodal analgesia, and non-pharmacological. The search terms were combined in various ways to give different results. For example, on PubMed ((Pain management) AND (orthopedic patients)) AND (non-opioid) yielded 42 results while (((opioid) AND (non-opioid)) AND (pain management)) AND (orthopedics) yielded 11 results. The inclusion and exclusion criteria below reduced the articles from 146 to 6. A major adjustment made to the inclusion criteria was to relax the restriction on study design. Limiting the articles to systematic reviews and randomized controlled trials reduced the final list to two articles. Therefore, other design studies were included to expand the articles to 6. Table 1: contains the inclusion and exclusion criteria and Figure 1: the PRISMA Flow Diagram