Abstract: Objective Basing on the concept of multimodal analgesia and preemptive analgesia,we evaluated the effect of parecoxib sodium preemptive analgesia and lidocaine combined with patient-controlled intravenous analgesia (PCIA) on postoperative pain,analgesic use,function recovery,inflammatory and stress response and perioperative safety after TKA and THA. Methods One hundred and thirty-six patients who were admitted and had the open operation in our hospital from January,2015 to January,2016 were randomly divided into 2 groups.The study group received a single 40 mg dose of parecoxib sodium 30 minutes before incision,the night on the operation day and 24 hours after the operation along with PCIA morphine,who has the injection of lidocaine on the subcutaneous tissue of incision before the end of the operation.The control group received only saline and PCIA morphine for postoperative pain management.Clinical outcomes were evaluated by visual analogue scale (VAS)(3,12,24,48 h after the operation) and the index like body temperature,leukocyte count,hypersensitive C reactive protein (hs-CRP),and blood glucose. Results VAS were improved significantly in the study group compared with the control group at all the observation points in the 48 h after surgery (P<0.05).The body temperature,leukocyte,hs-CRP and the blood glucose were also significantly decreased in the study group.There was no difference between the two groups in the incision healing rate,volume of drainage,blood transfusion rate and complications. Conclusion The multimodal analgesia regime combining parecoxib sodium,lidocaine and PCIA significantly can improve postoperative VAS,reduce morphine consumption and decrease inflammatory response without increasing the risks of bleeding and other adverse events,which should be further application and promotion in clinic.