Significant Anxiolytic Effect and Enhanced Recovery Benefits of Perioperative Low-Dose Olanzapine in Patients with Anxiety Undergoing THA: A Randomized Controlled Trial.

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Study Summary

135 patients with hip osteoarthritis and clinically important anxiety symptoms undergoing primary total hip arthroplasty (THA) were randomized to receive perioperative low-dose olanzapine (2.5 mg), alprazolam (0.4 mg), or placebo. The primary outcome was anxiety severity, measured using the State-Trait Anxiety Inventory-State (STAI-S). Secondary outcomes included sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI), pain measured using the visual analogue scale (VAS), opioid consumption, postoperative nausea and vomiting, and hip function assessed using the Harris Hip Score (HHS) and Hip Disability and Osteoarthritis Outcome Score (HOOS). Outcomes were assessed up to 24 weeks postoperatively. Overall, the results of the study revealed that olanzapine significantly reduced early postoperative anxiety, pain, opioid consumption, and nausea and vomiting while improving sleep quality and functional recovery compared with placebo, with greater early anxiolytic benefits than alprazolam. These findings suggested that short-term, low-dose olanzapine could improve perioperative recovery in patients with anxiety undergoing THA.