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Randomised controlled trials and meta\u2010analyses published between July 2010 and December 2019 assessing postoperative pain using analgesic, anaesthetic, surgical or other interventions were identified from MEDLINE, Embase and Cochrane databases. Five hundred and twenty studies were initially identified, of which 108 randomised trials and 21 meta\u2010analyses met the inclusion criteria. Peri\u2010operative interventions that improved postoperative pain include: paracetamol; cyclo\u2010oxygenase\u20102\u2010selective inhibitors; non\u2010steroidal anti\u2010inflammatory drugs; and intravenous dexamethasone. In addition, peripheral nerve blocks (femoral nerve block; lumbar plexus block; fascia iliaca block), single\u2010shot local infiltration analgesia, intrathecal morphine and epidural analgesia also improved pain. Limited or inconsistent evidence was found for all other approaches evaluated. Surgical and anaesthetic techniques appear to have a minor impact on postoperative pain, and thus their choice should be based on criteria other than pain. In summary, the analgesic regimen for total hip arthroplasty should include pre\u2010operative or intra\u2010operative paracetamol and cyclo\u2010oxygenase\u20102\u2010selective inhibitors or non\u2010steroidal anti\u2010inflammatory drugs, continued postoperatively with opioids used as rescue analgesics. In addition, intra\u2010operative intravenous dexamethasone 8\u201310\u00a0mg is recommended. Regional analgesic techniques such as fascia iliaca block or local infiltration analgesia are recommended, especially if there are contra\u2010indications to basic analgesics and\/or in patients with high expected postoperative pain. Epidural analgesia, femoral nerve block, lumbar plexus block and gabapentinoid administration are not recommended as the adverse effects outweigh the benefits. Although intrathecal morphine 0.1\u00a0mg can be used, the PROSPECT group emphasises the risks and side\u2010effects associated with its use and provides evidence that adequate analgesia may be achieved with basic analgesics and regional techniques without intrathecal morphine.<\/jats:p>","DOI":"10.1111\/anae.15498","type":"journal-article","created":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T17:45:06Z","timestamp":1621532706000},"page":"1082-1097","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":289,"title":["PROSPECT guideline for total hip arthroplasty: a systematic review and procedure\u2010specific postoperative pain management recommendations"],"prefix":"10.1111","volume":"76","author":[{"given":"M.","family":"Anger","sequence":"first","affiliation":[{"name":"Service d\u2019Anesth\u00e9sie R\u00e9animation et M\u00e9decine P\u00e9ri\u2010op\u00e9ratoire CHU Rennes Universit\u00e9 Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Valovska","sequence":"additional","affiliation":[{"name":"Service d\u2019Anesth\u00e9sie R\u00e9animation et M\u00e9decine P\u00e9ri\u2010op\u00e9ratoire CHU Rennes Universit\u00e9 Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Beloeil","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Henry Ford Health Systems Wayne State School of Medicine Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Lirk","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Brigham and Women\u2019s Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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