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There are considerable numbers of surgical procedures carried out daily. These may range from simple routine operations to highly complex events but a common denominator is postsurgical pain. Many patients have surgery for cancer, and persisting pain is a major issue in cancer survivors. Indeed, preclinical studies clearly reveal that general anaesthesia does not suppress the activity of pain-responsive neurones at spinal and brain levels, although it obviously causes unconsciousness and so no pain perception. However, pain-related activity caused by surgery has the potential not only to produce intense postoperative pain but also long-term consequences. These may be cases of chronic postsurgical pain but in early life, uncontrolled pain may alter the vulnerable developing nervous system with lifelong consequences. We are lucky to have two timely and thoughtful reviews in this issue – one by Bruhn et al. (pp. 106–111) on the clinical application of perioperative multimodal analgesia, whereas the other, by Moultrie et al. (pp. 112–117), covers the hugely important treatment of infant pain.
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