Although traditional methods of administering postoperative analgesia may be inadequate, they do have the merit of simplicity and familiarity carries a degree of inherent safety. Of the newer techniques which have been introduced, perhaps patient-controlled analgesia has the greatest degree of inherent safety but mishaps may arise as a result of programming error or machine failure. Extradural techniques employing either local analgesic agents or opioids require enhanced patient monitoring. For many years, advanced techniques of analgesia have been employed safely by retaining patients in intensive care units or, in many European centres, in high dependency nursing areas for 24–48 hours after surgery. The ability to finance time spent in treating patients in surgical wards postoperatively has recently enabled Ready and his colleagues to develop and operate an acute pain team to supervise patient-controlled analgesia and extradural opioid analgesia on normal surgical wards26. This work may help to identify those groups of patients who may be treated safely with advanced analgesic techniques on the normal wards and those who require high dependency nursing units.