*6.3.3 Post-operative analgesia*

Multimodal analgesia is a well proven analgesia technique within hip and knee arthroplasty [7, 8, 11, 12]. It targets pain through multiple different mechanisms of action to reduce sensation of pain while also reducing the side effects of any one agent. This has also been shown to limit requirement on opioid analgesia which reduces risk of short term side effects like nausea, vomiting, respiratory depression along with long term addiction and development of chronic pain [8]. This involves the use of paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) along with supplementary opioid analgesia [7, 8], although some of us (DJM) prefer tramadol 50 mg 3/24prn avoiding oxycodone in the vast majority of patients. There has also been evidence for the use of gabapentinoids post operatively that reduce postoperative opioid consumption, pruritus and nausea after joint arthroplasty along with improving sleep however no clear evidence on their role in post-operative pain [8].
