Comparison of ERAS-based multimodal pain nursing versus conventional analgesic care on postoperative pain and recovery after total hip arthroplasty: A retrospective study

This study aimed to retrospectively compare the effects of enhanced recovery after surgery (ERAS)-based multimodal pain nursing with conventional analgesic care on postoperative pain, opioid use, recovery, and complications in patients undergoing total hip arthroplasty (THA). A single-center retrospective study was conducted in 120 patients who underwent unilateral THA between March 2022 and April 2025. Patients were allocated to an ERAS group (n = 60) or a control group (n = 60) according to postoperative nursing protocols. Demographic and clinical data, perioperative pain management details, pain intensity, time to first ambulation, length of hospital stay, Harris hip scores, opioid consumption within 48 hours (morphine milligram equivalents), and postoperative complications were collected. Pain intensity was assessed using the numerical rating scale at 6, 12, 24, 48, and 72 hours postoperatively. Statistical analyses were performed using SPSS 26.0. Baseline characteristics were comparable between groups (all P > .05). Compared with conventional care, the ERAS group had significantly lower numerical rating scale scores at 6, 12, 24, 48, and 72 hours after surgery (all P < .05), lower opioid consumption within 48 hours (39.6 ± 7.9 vs 52.4 ± 10.2 morphine milligram equivalents, P < .001), earlier ambulation (23.1 ± 5.0 vs 31.2 ± 6.3 hours, P < .001), shorter hospital stay (7.3 ± 1.5 vs 9.0 ± 1.7 days, P < .001), and higher Harris hip scores at 1 month (86.8 ± 5.5 vs 80.1 ± 6.0, P < .001). The overall complication rate within 3 days postoperatively was significantly lower in the ERAS group (11.7% vs 46.7%, P < .001), particularly for drug-related adverse effects such as nausea and vomiting. ERAS-based multimodal pain nursing provides superior analgesia, reduces opioid requirements, minimizes postoperative complications, and promotes faster functional recovery following THA. This evidence supports the integration of ERAS principles into perioperative pain management protocols to enhance recovery quality and patient safety in orthopedic nursing practice.