Post operative pain following cardiac surgery is typically minimal and manageable. Pain should be approach with an eye towards minimization of narcotics as earlier as possible in the post-operative course. The concept of “multimodal analgesia” should be employed with a combination of acetaminophen, low dose oral opioids, NSAIDS, and less frequently, anti-convulsants and muscle relaxants.

Rafiq S1, Steinbr├╝chel DA, Wanscher MJ, Andersen LW, Navne A, Lilleoer NB, Olsen PS. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial.
J Cardiothorac Surg. 2014 Mar 20;9:52. doi: 10.1186/1749-8090-9-52