The First 24 Hours After Surgery

Part of The Joint Replacement Guide — Phase 5: Recovery and Rehabilitation · Article 28 of 42 · Hip & Knee

Key Points

  • Pain, drowsiness and some swelling are normal and expected in the first day, and are actively managed by your team.
  • Most patients are helped to sit up and often stand within hours of surgery, not days.
  • A urinary catheter is sometimes used temporarily, particularly after spinal anaesthesia, and is generally removed early.
  • This first day sets the pattern for your recovery, so engaging with it, even when uncomfortable, genuinely helps.

Pain and How It’s Managed

Some pain and discomfort is a normal, expected part of the first 24 hours, but it should be manageable rather than overwhelming — your team’s goal is to keep your pain controlled enough that you can move, breathe deeply, and rest reasonably comfortably. Pain relief typically combines the effects of any nerve block given during surgery, regular scheduled painkillers (often paracetamol and anti-inflammatories, where suitable for you), and additional stronger medication available if needed. Do tell your nursing team honestly if your pain isn’t controlled — this is common, expected feedback, not a complaint, and adjustments can usually be made quickly.

Getting Up and Moving

As covered in the previous article, most patients are helped to sit out of bed, and often to stand and take a few assisted steps, on the day of surgery itself, once alert and comfortable enough. This is not being rushed unnecessarily — early mobilisation is one of the most evidence-backed elements of modern recovery, reducing the risk of blood clots and chest complications, and is a core part of Enhanced Recovery After Surgery protocols, covered in detail in the next article.

Catheters, Drips and Monitoring

A urinary catheter is sometimes placed temporarily, particularly if you’ve had a spinal anaesthetic, as this can affect bladder sensation for several hours — it is generally removed early, often the same day or the following morning, once you’re mobile. You may also have a drip (intravenous fluids) running for a period after surgery, and your observations (blood pressure, pulse, oxygen levels) will be checked regularly, gradually reducing in frequency as you stabilise.

Nausea, Grogginess and Appetite

Some nausea and grogginess, particularly after a general anaesthetic, is common in the first several hours and usually settles reasonably quickly, with anti-sickness medication available if needed. Your appetite may take a little time to return, and this is entirely normal — start with light food and fluids as tolerated, rather than forcing a full meal straight away.

In More Depth

The first 24 hours genuinely sets the tone for the rest of your recovery, which is part of why modern practice places so much emphasis on it — good pain control that allows you to move comfortably, early mobilisation, and prompt catheter and drip removal all work together to reduce complication risk and get you functioning again more quickly. Engaging actively with this process, even though the first day is naturally the most uncomfortable, tends to pay dividends over the following days and weeks, which links back to the earlier discussion in this guide about your own role in driving your outcome.

This article is general information and does not replace individual clinical advice. Please tell your nursing team about any pain, nausea or concerns you have — they expect and welcome this feedback.

Sources

  • ERAS Society — Enhanced Recovery After Surgery guidelines
  • Royal College of Anaesthetists — post-operative pain management guidance
  • NHS.uk — recovering from joint replacement surgery

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