abstract
Unrelieved acute pain produces undesirable effects that may influence a patient's recovery and even survival after surgery. It may also lead to the long-term problem of chronic post-surgical pain. Pain management techniques themselves carry risks so a careful consideration of the risk:benefit ratio is essential. An acute pain service should provide education and training to all staff members involved in pain control and advice on the management of more complex problems. The responsibility for assessing and addressing pain lies with the whole of the team, and the patient themselves play an important part in this process. Pain should be anticipated wherever possible and appropriate measures taken to prevent it. Communication is an essential part of optimizing safe, effective pain control. There are many simple measures using familiar drugs and techniques that can enhance pain control. Sometimes pain control measures fail and a suitable response should be implemented to address severe pain. Some patient groups offer particular challenges, but understanding possible difficulties often helps in managing these challenges. Pain should be considered the fifth vital sign.