Assuring a Painless Total Hip Arthroplasty: A Multimodal Approach Emphasizing Peripheral Nerve Blocks

Mark W. Pagnano, James Hebl, Terese Horlocker

Research output: Contribution to journalArticle

47 Scopus citations


A highly effective comprehensive multimodal pain protocol has evolved at our institution for both primary and revision hip and knee arthroplasty. At the center of this protocol are peripheral nerve blocks to deliver postoperative pain relief. Total hip arthroplasty patients receive a lumbar plexus block with an indwelling catheter. Total knee arthroplasty patients receive a femoral nerve block with an indwelling catheter and also get a single-shot sciatic nerve block. Before surgery, patients are given a long-acting oral narcotic medication and a nonsteroidal anti-inflammatory. After surgery, oral medications are given on a set schedule and include acetaminophen, a nonsteroidal anti-inflammatory, and a long-acting oral narcotic. Outstanding pain control is achieved without parenteral narcotics and allows early physical therapy, early return to self-care, and improved patient satisfaction.

Original languageEnglish (US)
Pages (from-to)80-84
Number of pages5
JournalJournal of Arthroplasty
Issue number4 SUPPL.
StatePublished - Jun 1 2006



  • analgesia
  • pain management
  • regional anesthesia
  • total hip arthroplasty
  • total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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