Pain is a costly result of total joint replacement (TJR) surgery. The effect of pain can extend not only to chronic medical problems for patients but also to the hospital’s bottom line by decreasing patient satisfaction. A systematic literature search was performed, and evidence was appraised that supported the efficacy of a standardized multimodal pain management protocol to decrease pain and improve satisfaction in TJR patients. The evidence-based multimodal pain management protocol was implemented during a one-month period in patients undergoing total knee or total hip replacements. Key outcomes were examined and compared to the body of evidence and to a comparable group of patients in a retrospective review. The multimodal group had improvement in all outcomes measured compared to the retrospective group: 65% reduction in opioid use, 16% reduction in length of stay, 100% reduction in adverse outcomes, 21% reduction in the time to walk 200 feet, and 1% increase in patient satisfaction. Patients in the multimodal group reported 27% less pain on the day of surgery and 63% less pain on discharge from the facility than patients in the retrospective group who were not treated using the protocol. The multimodal analgesia protocol is safe and effective to improve patient outcomes with TJR while decreasing post-surgical pain.

Date of publication

Winter 12-2022

Document Type

DNP Scholarly Project



Persistent identifier


Committee members

Dr. Lauri John, PhD CNS RN, Dr. Cheryl Parker, PhD RN


Doctor of Nursing Practice

Available for download on Friday, December 06, 2024