Annuler
OK

Vous vous êtes déconnecté avec succès.

Multimodal Analgesia

Postoperative pain control

Multimodal analgesia combines different classes of analgesics to optimize postoperative pain relief while minimizing opioid use and associated side effects.1

Addressing the Opioid Crisis through Multimodal Analgesia

  • 0

    Opioid toxcity deaths per day on average

    (in 2024 in Canada)4

As the opioid epidemic continues to claim lives and strain healthcare systems, clinicians are shifting away from opioid-centric pain management models. Multimodal analgesia combines different analgesics to optimize post-operative acute pain relief while minimizing opioid use and opioid-related side effects.1 By tailoring therapy to each patient’s condition and pain sensitivity, it allows for effective control using the lowest necessary doses.2 The basic principle is to use enough to manage pain but as little as possible to avoid harm.3 

Analgesic Ladder for Acute Pain

Multimodal analgesia may significantly reduce the adverse effects of surgical injury, accelerate recovery, lower postoperative morbidity, and decrease overall healthcare costs.5

Multimodal pain management combines6:

  • Pharmacological therapies: Non-opioid analgesics (acetaminophen and NSAIDs) and adjuvants (antidepressants, anticonvulsants, and topical agents)
  • Non-pharmacological therapies: Physical therapy, occupational therapy, acupuncture, massage therapy, and cognitive-behavioral therapy
  • Opioids

The specific therapies used in multimodal pain management should be selected depending on the individual patient’s needs and condition.2 

Analgesia ladder

Therapy step 1

Non-Opioids ±
Adjuvants

Therapy step 2

Opioids for mild to moderate pain + Non-Opioids ± Adjuvants

Therapy step 3

Opioids for moderate to severe pain ± Non-Opioids ± Adjuvants

Therapy step 4

Invasive and minimally invasive treatments

Clinical Guidelines Supporting Multimodal Analgesia

  • Canadian Anesthesiologists’ Society (CAS) - Guidelines to the Practice of Anesthesia

    Revised Edition 2024

    link

    arrow_outward See more

  • American Pain Society - Guidelines on the Management of Postoperative Pain

    Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council

    link

    arrow_outward See more

  • The European Society of Regional Anaesthesia and Pain Therapy (ESRA) - Procedure-Specific Postoperative Pain Management (PROSPECT) Guideline

    Better Postoperative Pain Management

    link

    arrow_outward See more

  • National Institute for Health and Care Excellence - NICE Guideline NG180 (UK)

    Perioperative care in adults: [N1] Evidence reviews for managing acute postoperative pain

    link

    arrow_outward See more

Frequently Asked Questions (FAQs)

Untitled design - 1

Common pharmacological therapies include acetaminophen, NSAIDs, local anesthetics, and opioids.6 These are often combined to improve pain relief and reduce opioid use.1 

Learn about Intravenous Acetaminophen

Ensuring compliance in pediatric drug delivery is a complex but critical aspect of effective treatment and patient wellbeing. Many children struggle to swallow pills or tablets, making age-appropriate and easy-to-administer formulations essential.7 Liquid formulations offer key advantages in pediatric care, enabling flexible dosing and easier administration; it is particularly beneficial for children who struggle with swallowing pills or tolerating solid medications.7

B. Braun has developed an intravenous acetaminophen for pediatric patients aged 2 years and older, available in a 100 mg/10 mL container. 

Learn about Pediatric Multimodal Analgesia

Advantages of Multimodal Analgesia

According to a study at a large North American medical center, multimodal analgesia was linked to shorter hospital stays and improved bed availability compared to traditional pain management—benefits that may extend to similar healthcare settings.8

  • 0

    fewer hospital days per patient8

  • 0

    additional bed days (during the study duration)8

Patient benefits:

  • Reduced opioid use and its related side effects9, 10
  • Decreased duration of inpatient hospital stay9
  • Improved pain control satisfaction10
  • Lower risk of developing opioid addiction10

Hospital benefits: 

  • Reduced length of hospital stay8 
  • Increased bed availability8
Pain Management in Pediatrics 

Managing pain in pediatric patients presents unique challenges, especially in anesthesia where smaller patients often mean bigger complexities.

From 1999 to 2021, opioids were involved in approximately 33% of pediatric overdose deaths in North America.11 The majority of these deaths were unintentional, highlighting the urgent need for safer and more effective pain management strategies for children.11 With up to 82% of hospitalized children experiencing moderate to severe pain, effective pain management is a critical priority in pediatric care.12 

Although there are no specific guidelines for prescribing opioids to pediatric patients, clinicians are encouraged to prioritize non-opioid alternatives before considering opioids.13 Growing awareness of opioid risks is shifting attention toward multimodal pain therapy in children.

Acetaminophen, a first-line option in multimodal analgesia, is one of the most commonly used non-opioid analgesics in pediatric care (> 2 years of age).14

B. Braun offers acetaminophen for injection formulation in a 100 mg/10 mL presentation, designed for safe and effective use in children.

Friendly pediatrician entertaining his patient
Acetaminophen: The First-Step Relief in Multimodal Analgesia
Untitled design - 1

The World Health Organization (WHO) recommends starting pain management with non-opioids like acetaminophen before escalating to opioids. As part of a multimodal approach, B. Braun’s acetaminophen for injection provides rapid-onset pain relief while helping reduce opioid use.15

Learn about B Braun's Acetaminophen for Injection

Acetaminophen for Injection provides fast pain relief and supports efforts to reduce opioid use. Complete the form below, and a B. Braun representative will contact you.

Ready to simplify your drug administration process?

* Asterisk indicates required field

Character limit exceeded: Characters: 0/5000

B. Braun may use your contact information to send you emails about our business products and service offerings. For more information see our Privacy Policy.

check_circle

Your request could not be submitted. Please try again.

warning

References

  1. Wick EC, Grant MC, Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques: A Review. JAMA Surg. 2017;152(7):691-697. doi:10.1001/jamasurg.2017.0898
  2. Vargas-Schaffer G. Is the WHO analgesic ladder still valid? Twenty-four years of experience. Can Fam Physician. 2010;56(6):514-e205.
  3. Nicholas TA 4th, Robinson R. Multimodal Analgesia in the Era of the Opioid Epidemic. Surg Clin North Am. 2022;102(1):105-115. doi:10.1016/j.suc.2021.09.003
  4. Health Canada. Opioid- and Stimulant-related Harms in Canada. 2025. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/ 
  5. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606-617. doi:10.1093/bja/78.5.606
  6. Anekar AA, Hendrix JM, Cascella M. WHO Analgesic Ladder. StatPearls. 2023. https://www.ncbi.nlm.nih.gov/books/NBK554435/
  7. Kapoor DU, Gaur M, Patel MB, et al. Pediatric drug delivery challenges: Enhancing compliance through age-appropriate formulations and safety measures. J Drug Deliv Sci Technol. 2024; 96: 105720. https://doi.org/10.1016/j.jddst.2024.105720
  8. Beck DE, Margolin DA, Babin SF, Russo CT. Benefits of a Multimodal Regimen for Postsurgical Pain Management in Colorectal Surgery. Ochsner J. 2015;15(4):408-412.
  9. Hyderi AF, Racelis MC. A Comparison of Patient Outcomes Using Multimodal Analgesia Versus Opioid-Based Pain Management in Total Joint Arthroplasty. Orthop Nurs. 2021;40(6):360-365. doi:10.1097/NOR.0000000000000807
  10. Ilyas AM, Sundaram P, Plusch K, Kasper A, Jones CM. Multimodal Pain Management After Outpatient Orthopedic Hand Surgery: A Prospective Randomized Trial. J Hand Surg Glob Online. 2023;6(1):16-20. Published 2023 Oct 1. doi:10.1016/j.jhsg.2023.07.021
  11. Assen K, Urbantke E, Wilson M, Rieder M. Opioid deaths in children in Ontario: A province-wide study. Paediatr Child Health. 2024;30(3):122-125. Published 2024 Oct 10. doi:10.1093/pch/pxae064
  12. O'Donnell FT, Rosen KR. Pediatric pain management: a review. Mo Med. 2014;111(3):231-237.
  13. Wren AA, Ross AC, D'Souza G, et al. Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids. Children (Basel). 2019;6(2):33. Published 2019 Feb 21. doi:10.3390/children6020033
  14. Yaster M. Multimodal analgesia in children. Eur J Anaesthesiol. 2010;27(10):851-857. doi:10.1097/EJA.0b013e328338c4af
  15. WHO Guidelines for the Pharmacological and Radiotherapeutic Management of Cancer Pain in Adults and Adolescents. Geneva: World Health Organization; 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537492/