Effective and safe pain management for a patient emerging from the effects of anesthesia is a specialized skill that is often acquired only through years of experience. This article provides perianesthesia nurses with a technique to assess the cognitively impaired postanesthesia patient and to incorporate vital circumstantial criteria in determining the presence of pain. Intervention recommendations are also included. The pain management algorithm includes research-based information from the following sources: Pain: Clinical Manual (ed 2), by pain nurse experts Margo McCaffery, RN, MS, FAAN, and Chris Pasero, RN, MS; and the American Pain Society's Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain (ed 4). Parameters are incorporated for clinical use.