Objective: To describe early postoperative pain burden, pain management practices, and selected descriptive pain-care variables after total hip arthroplasty at a Vietnamese tertiary hospital.
Methods: This prospective observational study included 117 adults undergoing unilateral total hip arthroplasty at Cho Ray Hospital from May 2025 to April 2026. Pain was assessed on a 0–10 scale at 6, 24, 48, and 72 hours at rest and during clinically feasible activity. Early severe pain was defined as any score ≥7 at 6 or 24 hours. Descriptive analyses and exploratory multivariable logistic regression were performed.
Results: Median age was 54 years and 71.8% were male. Pain on admission was present in 99.1%, and 80.3% had preoperative analgesic or opioid use. Early severe pain occurred in 36.8%. At 72 hours, mean pain was 4.38 ± 1.34 at rest and 5.53 ± 1.26 during activity. Paracetamol, source-coded opioid therapy, tramadol, and NSAIDs were recorded in 98.3%, 93.2%, 19.7%, and 9.4%, respectively; no peripheral nerve block was documented. In exploratory multivariable analysis, higher BMI (adjusted OR 1.24, 95% CI 1.07–1.43; p=0.003), broadly coded musculoskeletal history (3.39, 1.30–8.81; p=0.012), and recorded tramadol/Ultracet use (0.29, 0.09–0.96; p=0.043) were associated with early severe pain.
Conclusions: Substantial pain burden persisted during the first 72 hours after total hip arthroplasty. Standardized documentation of the activity associated with each pain score, analgesic agent, dose, route and timing, reassessment before and after mobilization, and mobility details is needed. The source-coded opioid prevalence should not be interpreted as a measure of opioid exposure or guideline concordance.