In 1990, The Royal College of Surgeons of England
(RCS) identified the failure of conventional treatments
for postoperative pain and highlighted the fact that despite
significant advances in the use of medication and pain
relieving techniques (such as epidural analgesia, local
anaesthetics and new opioid formulations), there continued
to be a failure to provide optimal pain relief following
surgery (RCS, 1990). At that time, the RCS (1990)
recommended the introduction of specialist acute pain
services (APS) in order to coordinate and micro-manage
postoperative pain, provide education, develop protocols
and facilitate the use of sophisticated analgesia techniques
on general wards. Since then, Bennett and Carr (2001)
were able to identify barriers to effective practice including
inadequate knowledge of pain management techniques and
pharmacological principles, opiophobia (as a result of fears
of addiction and potential side effects of opioids), unclear
lines of accountability for pain management and poor pain
assessment.