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A knowledge of the natural history of postoperative pain is of importance in at least two respects. It will help the clinician, who finds its treatment is at present unsatisfactory. There is a pressing need for greater efficiency in meeting this problem (Editorial, 1953; Leading articles, 1964; Simpson and Parkhouse, 1961). In the field of research, the extent of the relief of postoperative pain has been much used in clinical trials designed to assay the efficacy of analgesic agents (Lee, 1942; Denton and Beecher, 1949; Masson, 1962; Parkhouse, 1967). To be meaningful, the design of such trials must take into consideration the various factors influencing the degree and course of postoperative pain. Although incidence and severity are obviously closely related, these two facets of pain after operation will be dealt with separately.

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An assessment of the general properties of fentanyl and phenoperidine has been made by including them in the continuing trial of drugs given before anaesthesia. Fentanyl and phenoperidine both differed from morphine in that they produced much less sedation, while the incidence of restlessness was greater after fentanyl than it was with morphine or phenoperidine. None of the drugs had any remarkable effect on cardiovascular system stability, although both fentanyl and phenoperidine were associated with a notable incidence of tachycardia. Neither drug showed as strong an emetic effect as did morphine, phenoperidine causing the least sickness while fentanyl occupied an intermediate position. The effect of addition of droperidol to fentanyl and phenoperidine was to increase the sedative effect over that of either drug given alone, whilst the unpleasant subjective effects and restlessness associated with droperidol given alone were also reduced by combination with the opiates. The anti-emetic effect of droperidol was confirmed.