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Background and Aims This service evaluation aimed to reassess postoperative pain and opioid requirement following primary and revision elbow arthroplasty and compare them to previous data from 2019.

Methods We collected data retrospectively from January 2020 to December 2023 for patients undergoing elbow arthroplasty. We recorded type of surgery, regional anaesthetic block placed, local anaesthetic used, intraoperative and postoperative opioid consumption and pain scores on days 0, and 1.

Results Data were collected from 28 patients, in comparison to 22 patients in 2019. The mean opioid consumption (equivalent to i.v. morphine) in the current evaluation was 5 and 10mg on days 0, and 1 respectively. This compares to 14 and 20mg on days 0 and 1 respectively in 2019. Pain scores were also lower than in 2019. Axillary brachial plexus blocks were performed more frequently than in 2019, levobupivacaine was the local anaesthetic of choice, and i.v. dexamethasone was used routinely. The surgical guidelines had changed from 2019; tourniquets were no longer used intraoperatively.

Discussion We were satisfied that pain scores seemed satisfactory and similar to 2019 and that opioid requirements were reduced. Our use of axillary brachial plexus blocks as an effective block for elbow surgery has increased and use of dexamethasone has become standard. Abandoning tourniquet use may also be contributing to improved postoperative recovery quality. Conclusion: Opioid requirements after elbow arthroplasty procedures have decreased from 2019 to 2023. Changes in anaesthetic and surgical techniques and perioperative use of dexamethasone may have contributed to these changes.