A Collaborative Multimodal Pain Management Pathway Reduces Opiate Consumption After Total Hip and Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Multidisciplinary teams developed a multimodal pain management protocol for total hip and knee arthroplasty.
• The protocol aimed to decrease opioid use in patients undergoing these procedures.

Purpose of the Study:

• To evaluate the effectiveness of a multimodal pain management protocol in reducing opioid consumption after total hip and knee arthroplasty.

Main Methods:

• A retrospective cohort study compared 206 patients on the multimodal protocol with 249 patients receiving standard care.
• Data collected from January 2017 to March 2020 included postoperative morphine milligram equivalents (MMEs) per 24 hours, at discharge, and at 6 weeks post-discharge.

Main Results:

• The multimodal group showed significantly lower MMEs per 24 hours (57.0 vs. 84.7, P < .001).
• Opioid prescriptions at discharge (300 vs. 525, P < .001) and 6 weeks post-discharge (150 vs. 400, P = .01) were reduced.
• The multimodal protocol also led to a shorter length of stay (P = .01) with comparable pain scores.

Conclusions:

• The collaborative multimodal pain management pathway effectively reduced opioid consumption and length of stay for total hip and knee arthroplasty patients.
• The protocol demonstrated efficacy across varying patient opioid requirements, maintaining similar pain control.