AB189. SOH22ABS047. Pain control in same-day discharge total hip arthroplasty: a prospective cohort study

Background: Same-day total hip arthroplasty (SD-THA) is a relatively new practice in this country. In select patients, it can be a safe and effective help to early mobilization and rehabilitation. However, little is known about the differences in pain levels and analgesia use post-op between inpatient-stay (IPS) and same day discharge (SDD) post-THA. The aim of this study is to evaluate the impact of SD-THA on patient’s opioid consumption in the 2-week period after their operation.

Methods: This is a case-control study. Single surgeon, single center study. Surgeon directs toward either same day discharge or IPS at pre-assessment clinic. Sample size calculations determined a sample of 32 (16 SDD vs. 16 IPS) would be needed for a sufficient study population. With informed consent, subjects are all given a pain and medication diary to be filled in over a 2-week period post-op. Data collected from diary and Kardex. Exclusion criteria: diary filled in incorrectly; compliance issues; different surgeon or hospital; ASA >2. Primary outcome: total post-op opioid consumption over 2 weeks. Secondary outcomes: non-opioid analgesia use; pain scores; feasibility of pain diary.

Results: (Data collection ongoing) 10 diaries returned so far. In the hospital, analgesia is provided by nurses, who are required to give regular analgesia, regardless of pain levels. Initial results indicate inpatients who are staying overnight consume more analgesia, and opioid analgesia, than their SDD counterparts. This is despite the standard regimen prescribed for all patients post-operatively. Preliminary results show pain levels are similar between the groups (P<0.05). In addition, there are issues with filling out a simple pain diary.

Conclusions: Same-day discharge is a safe and effective practice in select patients. Duration of time spent in hospital after THA may have a bearing on postoperative opioid consumption.

Keywords: Analgesia use; day case hips; morphine equivalent doses; pain diary; same day hips