An Applied Study of Ulinastatin in Pain Management After Hip Replacement: Impact on Opioid Use.

ABSTRACT

Background: Due to the global prevalence of opioid drugs, postsurgical prescriptions can lead to substantial opioid consumption, highlighting the increasing need for alternative medications. Alternative medicines can markedly lessen the usage of opioids after surgery, but the variety and notable side effects of these alternatives require meticulous experimental support. Objective: This study explored the efficacy and safety of ulinastatin for alleviating postsurgical pain, for reducing the need for opioids, and for inclusion in conventional treatment methods. Methods: A total of 108 patients undergoing elective hip replacement were randomly allocated into either the experimental group (56 cases, standard pain relief treatment plus 60 IU ulinastatin) or the control group (40 cases, standard pain relief treatment). The main outcomes measured were the total consumption of opioids at 24, 48, and 72 h postoperatively. Secondary outcomes comprised patient-reported pain indices and levels of satisfaction with pain control. The frequency of adverse events evaluated medication safety. Results: There were no statistically significant differences in age, sex, or underlying diseases between the two groups. Over 24 hours, opioid consumption was higher in the standard treatment group (66.6 mg; mean difference [MD] 4.43 mg; 95% CI 57.6-75.5) than in the intervention group (54.5 mg; MD 1.91 mg; 95% CI 50.7-58.3). The standard treatment group exhibited a notably higher incidence of adverse reactions. However, there was no disparity in post-discharge satisfaction between the groups, with an odds ratio of 1.058 (95% CI 0.62-1.82; P > 0.05). Additionally, significant differences in C-reactive protein levels were observed immediately and 6 h after surgery between the two groups. Conclusion: Within 72 h post-surgery, ulinastatin was effective in substantially reducing the use of opioids while maintaining adequate pain control. Ulinastatin may be beneficial for postoperative pain management and for reducing the risks associated with opioid use. Registered ClinicalTrials.gov ChiCTR2300072126.