In the past, the role of adequate acute pain management in the successful outcome of a painful operation or other intervention was not fully recognised. There was a belief that acute pain following surgery was inevitable, that it was just a symptom, that it subsided in time, that it was not in itself harmful, and that patients should accept this. It was not recognised that acute pain management forms an integral part of the recovery process and that almost all systems are adversely affected by uncontrolled acute pain. Consequently, treatment was often inadequate and inappropriate.