Neuropathic pain is defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system'. This suggests that agents other than traditional analgesics may have a role to play in the management of postoperative pain. Pain is an individual experience that is influenced by culture. previous pain events. beliefs and moods, and is contextual: consider the different experiences associated with childbirth and that of a laparotomy for incurable cancer. Acute postoperative pain produces a number of adverse effects that may delay recovery and discharge, or lead to serious morbidity or death. The surgical stress response results in actiphvation of both the central and the peripheral nervous systems and a neuroendocrine response. These can result in physiological changes in all the major organ systems. Effective analgesia is capable of modifying many of the pathophysiological responses to injury hence assisting recovery, but confirmation that this improves outcomes or reduces mortality is hard to come by. Equally, the methods for controlling pain carry the risks of significant side-effects and complications so that pain managment should be tailored to an individual's needs.