Abstract： Objective： To observe the effect of thumb-tack needling for subcutaneous embedding and the five notes therapy in assisting postoperative analgesia in elderly patients undergoing hip replacement surgery using a selfcontrolled analgesia pump. Methods：A total of 84 elderly patients with hip fractures who underwent hip replacement surgery at the Bone Injury Center of Hainan Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine from January 2023 to January 2024 were randomly divided into the trial group and the control group， with 42 patients in each group，using the random envelope method. Both groups were intervened with Patient-Controlled Analgesia （PCA）. The trial group was treated with thumb-tack needling for subcutaneous embedding and the five notes therapy，while the control group was treated with false thumb-tack needling for subcutaneous embedding （only adhesive tape was used after selecting the acupoints，without pressing） and false five notes therapy （the audio broadcast content was CCTV News）. The intervention period was from three hours to three days after surgery. Compared the scores of National Rating Scale for Pain （NRS），the severity of nausea and vomiting，heart rates and respiratory rates，as well as the time and number of first presses of the analgesic pump within 72 hours after surgery between the two groups. Results： There was no significant difference in NRS scores between the two groups one day before surgery and two hours after surgery（ P＞0.05）. At 4，24，48，and 72 hours after surgery，the NRS scores in the trial group were lower than those in the control group （P＜0.05）. At 30 minutes after surgery， there was no significant difference in the severity of nausea and vomiting between the two groups （P＞0.05）；at 4 hours，24 hours，48 hours，and 72 hours after surgery，the severity of nausea and vomiting in the trial group was better than that in the control group （P＜0.05）. The first compression time of the analgesic pump in the trial group was longer than that in the control group （P＜0.05）， and the number of compressions of the analgesic pump was less than that in the control group （P＜0.05）. One day before surgery，there was no significant difference in heart rates and respiratory rates between the two groups （P＞0.05）；at 72 hours after surgery，the heart rates and respiratory rates in both groups were decreased when compared with those one day before surgery （P＜0.05）， and the heart rate and respiratory rate in the trial group were lower than those in the control group （P＜0.05）. At 72 hours after surgery，there were no significant differences in the incidence of dizziness， loss of appetite， dry mouth， and shivering between the two groups （P＞0.05）. Conclusion： The combination of thumb-tack needling for subcutaneous embedding and the five notes therapy can effectively assist in drug analgesia， alleviate postoperative nausea and vomiting symptoms，and have a stabilizing effect on vital signs such as heart rates and respiratory rates.