What will give me the most pain relief with the least nausea/constipation?

[Psynaught]

I have just gotten full shoulder replacement and am on the "multimodal pain management" system. It sucks. I am getting less pain relief, more nausea and constipation than when I just took Tylenol and Oxy. I have pretty much everything including Tramadol and Fentanyl. What has the best pain relief to nausea/constipation ratio?