Acute post‐operative pain is a normal response to surgical intervention and must be managed effectively (Lovich‐Sapola et al. [111]). Effective management of pain following surgery requires that information about the patient's goals for pain relief, previous history with analgesics and type of surgical procedure is used to guide decisions about analgesic regimens (Bell and Duffy [30], Layzell [96]). It is imperative that the patient's pain is managed well, initially by the anaesthetist and then the ward staff and pain team to ensure that the patient has adequate analgesia but is alert enough to be able to communicate and co‐operate with staff (Liddle [104]). Analgesics are selected based on the location of the surgery, the degree of anticipated pain and patient characteristics (e.g. co‐morbidities); routes of administration and dosing schedules aim to maximize the effectiveness and safety of analgesia while minimizing the potential for adverse events (Layzell [96]).

Pain management can be delivered using the following routes: oral, rectal, epidural and intravenous (including patient‐controlled analgesia and opioid continuous infusion) (Liddle [104]). A pain tool (e.g. verbal numeric rating score) should be used to assess the effectiveness of prescribed analgesia and action should be taken if the patient's pain is not controlled. See Chapter c10: Pain assessment and management for further information concerning effective management of pain following surgery, including assessment tools.