Multimodal analgesia did not improve post-operative pain scores, reduce opioid consumption or reduce length of stay following hip arthroscopy

Abstract

PurposeTo determine whether different regimens of multimodal analgesia will reduce postoperative pain scores, opioid consumption, costs and hospital length‐of‐stay following hip arthroscopy. MethodsFrom 2018 to 2021, 132 patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) were included in this prospective, single‐center randomized controlled trial. Patients were randomized into four treatment groups: Group 1—Control: opioid medication (oxycodone‐acetaminophen 5 mg/325 mg, 1–2 tabs q6H as needed), Heterotopic ossification prophylaxis—Naprosyn 500 mg twice daily × 3 weeks); Group 2—Control + postoperative sleeping aid (Zopiclone 7.5 mg nightly × 7 days); Group 3—Control + preoperative and postoperative Gabapentin (600 mg orally, 1 h preoperatively; 600 mg postoperatively, 8 h following pre‐op dose); Group 4—Control + pre‐medicate with Celecoxib (400 mg orally, 1 h preoperatively) The primary outcome was pain measured with a visual analog scale, monitored daily for the first week and every other day for 6 weeks. Secondary outcomes included opioid consumption, healthcare resource use, and hospital length of stay. ResultsPatient characteristics were similar between groups. There were no statistically significant differences in pain scores between groups at any timepoint after adjusting for intra‐operative traction time, intra‐operative opioid administration and preoperative pain scores (p > 0.05). There were also no significant differences in the number of days that opioids were taken (n.s.) and the average daily morphine milligram equivalents consumed (n.s.). Similarly, there were no statistically significant differences in length of stay in the experimental groups, compared with the control group (n.s.). Finally, there were no differences in cost between groups (n.s.). ConclusionThe routine use of Zopiclone, Celecoxib and Gabapentin did not improve postoperative pain control or reduce length‐of‐stay following hip arthroscopy. Therefore, these medications are not recommended for routine postoperative pain control following hip arthroscopy. Level of evidencel.