ArticleInternational journal of surgery (London, England)2026
Efficacy of short-term, low-dose oral olanzapine at reducing perioperative anxiety, pain, and enhancing recovery in patients undergoing primary total joint arthroplasty.
Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSignificant perioperative anxiety can exacerbate pain and compromise joint recovery in patients undergoing total joint arthroplasty (TJA). Given the ability of the olanzapine to reduce anxiety, treat chronic pain and sleep disorder, we wondered whether it might help improve the outcomes in anxious patients undergoing primary TJA.
methodsThis is a double-blind randomized controlled study. We prospectively enrolled 101 patients who were scheduled for primary total hip or knee arthroplasty (THA/TKA) at our institution between January 2023 and February 2024 and who scored at least 40 on the State-Trait Anxiety Inventory-State (STAI-S) before surgery. Patients were randomized to receive oral olanzapine (2.5 mg once nightly for 5 days, starting on the day of admission) or placebo. The two groups were compared postoperatively in terms of STAI-S score, the Visual Analogue Scale- Sleep disorder (VAS-S), the VAS-Pain score, opioid consumption and functional recovery of the joint.
resultsOlanzapine was associated with significantly lower STAI-S score on the night before surgery and on POD 1 and 3, better sleep quality based on a VAS-S on PODs 1-3, lower pain for resting VAS-P on PODs 1-3, as well as lower opioid consumption on PODs 2 and 3. Patients in the olanzapine group exhibited better hip function in terms of the Harris Hip Score and range of motion during hip flexion and abduction. The two groups did not differ significantly in adverse events.
conclusionsShort-term, low-dose oral olanzapine can reduce perioperative anxiety, sleep disorder and mitigate postoperative pain in anxious patients undergoing primary THA or TKA. In those undergoing THA, it can also enhance hip functional recovery.
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