For a postoperative patient with moderate pain who is opioid-naïve, what is the recommended analgesia approach?

• A. Use multimodal analgesia with non-opioid alternatives and/or a lower-dose opioid, and reassess before increasing dose.
• B. Give a high-dose opioid immediately
• C. Avoid non-opioid analgesics
• D. Use only non-pharmacologic methods

Answer: (A)

Multimodal analgesia is the approach here: control pain through multiple pathways while minimizing opioid exposure. For an opioid-naïve patient with moderate postoperative pain, start with non-opioid options such as acetaminophen and an NSAID if not contraindicated, since they provide meaningful analgesia with a lower risk of sedation and respiratory depression. Incorporate regional techniques or adjuvants when appropriate to further reduce pain without relying solely on opioids. If pain remains moderate after non-opioids, use a low-dose opioid rather than loading with a high dose, and reassess the patient before increasing the dose to ensure the response guides titration. This strategy reduces opioid-related side effects, supports faster recovery, and avoids under-treatment of pain. The other approaches either miss the benefits of combining modalities, risk excessive opioid exposure, or rely exclusively on non-pharmacologic methods that are insufficient for moderate postoperative pain.