A recent randomized, blinded, placebo-controlled, trial in Denmark examined the efficacy of analgesia for 556 patients undergoing total hip arthroplasty (THA). Options for analgesia included paracetamol (acetaminophen) 1000 mg plus ibuprofen 400 mg, paracetamol 1000 mg plus placebo, ibuprofen 400 mg plus placebo, or half-strength paracetamol 500 mg plus ibuprofen 200 mg: all were administered orally every 6 hours for 24 hours postoperatively, beginning an hour before surgery. There were two co–primary outcomes: 24-hour morphine consumption using patient-controlled analgesia, and the proportion of patients with one or more serious adverse events (SAEs) within 90 days of surgery. The mean age of the participants was 67 years and a gender split close to 50:50
Median 24-hour morphine consumption was 20 mg in the paracetamol/ibuprofen group, 36 mg for paracetamol alone, 26 mg for ibuprofen alone, and 28 mg for the half-strength combination. The proportion of patients with serious adverse events in groups receiving IBU was 15%, and in the PCM-alone group, was 11%. The study suggests that the structured use of these simple analgesics may reduce morphine use after hip surgery – given the complications associated with opioid use, it would appear that this approach is certainly worth applying in the post-operative context. See the details of the study here