In a multimodal analgesia plan to reduce opioid use after orthopedic surgery, which option is NOT recommended?

• A. Regional anesthesia and nerve blocks
• B. Acetaminophen
• C. NSAIDs
• D. High-dose opioid monotherapy without adjuncts

Answer: (D)

Multimodal analgesia relies on combining non-opioid strategies that address different pain pathways to reduce opioid needs. Regional anesthesia and nerve blocks deliver targeted, effective pain relief with minimal systemic opioids, often enabling earlier mobilization and fewer opioid-related side effects. Acetaminophen provides analgesia without significant sedation or respiratory depression and is commonly used regularly as a baseline part of pain control. NSAIDs add anti-inflammatory and analgesic effects and can further cut opioid requirements when there are no contraindications.

Relying on high-dose opioid monotherapy without adjuncts misses these non-opioid benefits and tends to increase the risk of adverse effects such as nausea, constipation, respiratory depression, and delirium, while offering less comprehensive pain control. That approach conflicts with the goals of multimodal analgesia, so it is not recommended.