Which analgesic approach is commonly used after thoracic surgery?

• A. Opioids contraindicated
• B. Analgesics for pain
• C. Only NSAIDs
• D. No analgesia

Answer: (B)

The main idea being tested is that effective pain control after thoracic surgery is essential to enable deep breathing and productive coughing, which helps prevent lung complications. Post-thoracotomy pain is substantial because the chest wall is involved, so without analgesia patients tend to breathe shallowly, have reduced chest wall movement, and can develop atelectasis or pneumonia. An analgesic plan should address this pain adequately, often through multimodal strategies that combine different types of medications and techniques to reduce overall opioid use while controlling pain. This usually includes systemic analgesics like opioids and nonopioids (acetaminophen, NSAIDs as appropriate), sometimes gabapentinoids, and regional methods such as thoracic epidural analgesia, paravertebral blocks, or intercostal nerve blocks to provide targeted relief. The goal is to keep pain controlled enough to permit deep breaths, effective coughing, and participation in chest physiotherapy.

Opioids are not contraindicated; they are commonly used but with careful dosing to minimize respiratory depression. Relying on only NSAIDs would not sufficiently address the full spectrum of postoperative pain or provide adequate relief for many patients. No analgesia would leave the patient in intolerable pain and markedly impair respiratory function.