An evaluation of a revised analgesia protocol for elective joint arthroplasty

Abstract

Aims
Mayo University Hospital performs approximately 350 joint arthroplasty surgeries per annum. We revised our analgesia protocol in 2024 based on best current practice.

Methods
We conducted this evaluation from January to July 2025. All patients presenting for joint arthroplasty surgeries were invited to be included.

Results
Our evaluation included 147 patients; 94 patients had a total hip arthroplasty and 53 had a total knee arthroplasty. The average age was 69 years, and 142 (96.5%) of patients were living at home independently before surgery. 53 (36%) were on prescribed analgesics pre-operatively. The average pain score on day 1 (day after surgery) was 4.8 for the hip arthroplasty patients and 5.5 for the knee arthroplasty patients. The total oral morphine equivalent requirements for the first 2 days were 48 mgs for the hip surgery patients and 65 mgs for the knee surgery patients. The median length of stay for all patients was 4 days. On follow up at 6 weeks, 135 (91%) of patients were mobilising independently. Overall satisfaction of the patient’s experience (0-10) was 8.7 for the knee arthroplasty patients and 8.8 for the hip arthroplasty patients.

Discussion
Overall, we were satisfied with our analgesic protocol, but we want to improve the day 1 and 2 pain scores particularly in the knee arthroplasty patients. We are discussing the introduction of adductor canal blocks pre-operatively.