Reduced opioids after total joint replacement surgery (REPAIRS): a pilot randomized controlled trial
Abstract
Opioid analgesics are commonly used for controlling pain after total knee or hip replacement. However, it is unclear how much opioid should be prescribed at discharge after total hip and knee replacement surgery to optimize pain management but minimise adverse events. To determine the acceptability and feasibility of a trial comparing a reduced and standard opioid regimen following discharge from total knee or hip replacement. This pilot randomized controlled trial recruited participants from the pre-admission clinic of a metropolitan hospital in Sydney. All participants received a non-opioid regimen of naproxen 500 mg 12 hourly for 7 days, and paracetamol 1000 mg 6 hourly daily for 14 days. Participants were randomly allocated to the ‘standard’ group (oxycodone 5 mg taken as needed, maximum recommended frequency of 4 hourly, 20 tablets dispensed) or the ‘reduced’ group (received half the amount of oxycodone, taken half as frequently) at hospital discharge. Primary outcomes were screening to recruitment rate, percentage completing follow-ups, and acceptability of the trial procedures. Acceptability was measured quantitatively at weeks 1 and 2 post-discharge and qualitatively by interview at 6 weeks post-discharge. Adverse events were collected up to 6-weeks post-discharge. In four months, we screened 254 people, of which 72 were eligible and 53 were recruited (recruitment rate = 21%). 93% participants completed all their follow up surveys. Participants scored the trial…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 254 participants or records.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.