Total hip arthroplasty in an outpatient setting in 27 selected patients

Figures & data

The standardized multimodal protocol for perioperative pain medication

2 hours before surgery on the ward:

• paracetamol (acetaminophen), 1,000 mg per os.

• celecoxib (Celebrex)^a, 400 mg per os.

• gabapentin, 600 mg per os.

Just before surgery:

• dexamethasone, 0.15 mg/kg iv.^b

• esketamine, 15 mg iv.

4 hours after surgery:

• paracetamol (acetaminophen), 1,000 mg per os.

8 hours after surgery:

• paracetamol (acetaminophen), 1,000 mg per os.

• gabapentin, 300 mg per os.

Before the night:

• oxicodone (OxyContin), 10 mg per os.

Day 1:

• paracetamol (acetaminophen), 1,000 mg per os 4 times a day.

• celecoxib (Celebrex)^a, 200 mg per os in the morning.

• gabapentin, 300 mg per os in the morning.

After day 1:

• paracetamol (acetaminophen), 1,000 mg per os 4 times a day (for a maximum of 2 weeks).

• celecoxib (Celebrex)^a, 200 mg per os in the morning (until 2 weeks after surgery).

Rescue medication:

• celecoxib (Celebrex)^a, 200 mg per os extra after the first night.

• piritramide (Dipidolor), 10 mg im, which could be repeated every 4 hours.

^a In combination with celecoxib (Celebrex), all patients receive omeprazole, 20 mg per os once a day as prophylaxis. When the patient is already using a proton pump inhibitor before admission, no omeprazole is administered.

^b Dexamethasone solution in 50 mL saline is administered slowly to avoid adverse side affects such as severe perianal pain.