Background Nearly half of adult patients undergoing surgery experience moderate or severe postoperative
pain. Inadequate pain management hampers postoperative recovery and function and may be associated with
adverse outcomes. This multidisciplinary consensus statement provides principles that might aid postoperative
recovery, and which should be applied throughout the entire peri-operative pathway by healthcare
professionals, institutions and patients,

Methods We conducted a directed literature review followed by a four-round modified Delphi process to
formulate recommendations for organisations and individuals.
Results We make recommendations for the entire peri-operative period, covering pre-admission; admission;
intra-operative; post-anaesthetic care unit; ward; intensive care unit; preparation for discharge; and
post-discharge phases of care. We also provide generic principles of peri-operative pain management that
clinicians should consider throughout the peri-operative pathway, including: assessing pain to facilitate
function; use of multimodal analgesia, including regional anaesthesia; non-pharmacological strategies; safe
use of opioids; and use of protocols and training for staff in caring for patients with postoperative pain.
Conclusions We hope that with attention to these principles and their implementation, outcomes for adult
patients having surgery might be improved.