Multimodal analgesia to reduce opioid use after orthopedic surgery typically includes which components?

• A. Regional anesthesia/nerve blocks, acetaminophen, NSAIDs, non-narcotic adjuncts, and early mobilization
• B. Opioid-only regimen
• C. Sedatives and hypnotics only
• D. Bed rest without analgesia

Answer: (B)

Multimodal analgesia uses several pain-control strategies that work through different mechanisms to achieve good pain relief while reducing opioid use after orthopedic surgery. Regional anesthesia or nerve blocks provide targeted, early pain relief at the surgical site, which often lowers the need for systemic opioids in the immediate postoperative period. Acetaminophen contributes central analgesia that can enhance overall pain control without adding opioid risk. NSAIDs address inflammation and pain through prostaglandin inhibition, supporting further opioid sparing. Non-narcotic adjuncts such as gabapentinoids, ketamine, lidocaine infusions, and similar options add additional analgesia without the typical opioid side effects. Early mobilization is also an important part of the plan, helping reduce pain from stiffness and guarding and promoting faster recovery. Together, these components create a synergistic approach that lowers opioid consumption while maintaining effective pain control.

An opioid-only regimen lacks these diverse modalities, so it wouldn’t be considered multimodal analgesia and is associated with higher opioid exposure and related side effects. Sedatives or hypnotics do not provide analgesia, and bed rest without analgesia obviously fails to control pain.