- Patients who underwent surgery for total hip replacement (THR) whose postoperative pain was managed with a multimodal analgesic regimen that included fixed-schedule doses of acetaminophen, meloxicam, and gabapentin and only a 2-day supply of prescription opioids reported superior pain relief than those managed with the traditional approach of as-needed opiates.
Why this matters
- Previously published research suggests that the demand for primary THR in the United States is estimated to grow by 174% by 2030.
- Parallel-group, cluster-randomized OPIOID study of 235 patients who, after undergoing THR, were randomly assigned to:
- multimodal analgesic regimen (fixed-schedule doses of acetaminophen, meloxicam, and gabapentin)+2-day opiate supply;
- multimodal analgesic regimen+2-week opiate supply; or
- acetaminophen+2-week opiate supply (control group).
- Funding: None disclosed.
- At 30 days, visual analog scale (VAS) pain scores were significantly lower with multimodal analgesia vs control group:
- 2-day opiate group: coefficient, −0.81 (P=.003).
- 2-week opiate group: coefficient, −0.61 (P=.021).
- VAS pain scores were not significantly different between the 2 multimodal analgesic groups.
- Multimodal analgesic with 2-day opiate supply had significantly lower:
- daily morphine equivalents vs 2-week supply (coefficient, −0.46; P=.002) and control group (coefficient, −0.77; P<.001 and>
- composite opioid-related symptom distress scale score vs control group (P=.005).
- Patient-reported opioid consumption.
Coauthored with Antara Ghosh, PhD