ANY major operation inevitably brings pain in its wake. Right? No, not necessarily.

Imagine being able to sit up hours after surgery, being able to eat and see visitors.

According to a growing number of medical professionals, it is not a pipe dream, but the way it should be in the majority of hospital cases. Post-operative pain, they say, is not only unnecessary but can hamper recovery time.

Patients suffering severe pain are less likely to move about, much less likely to get out of bed, which increases the possiblity of thrombosis and pressure sores. Breathing can be more laboured, making chest infections more likely and pain can also lead to a rise in blood pressure.

With all these potential problems, you would expect hospitals to keep patients as comfortable as possible so they can make a speedy recovery and get home quickly. But that's not the case according to Professor Leo Strunin, President of the Royal College of Anaesthetists. He quotes an audit commission survey of English and Welsh health authorities which found that only half of those asked offered proper analgesic care.

Pain relief following surgery is traditionally provided by a standard regime of injections, administered to a set pattern and format regardless of the difference between patients.

Professor Strunin believes hospitals should have dedicated teams to tailor pain relief to individual patients.

He says: "Most of the pain after operations can be avoided. It needs every patient going into hospital to say, 'I am not having an operation unless you tell me how you are going to manage my pain afterwards'''

Guy's and St Thomas' Hospital Trust in south London recently set up an acute pain relief team made up of four dedicated nurses and a pharmacist with support from three consultant anaesthetists.

Dr David James, one of the anaesthetists, said the whole issue of pain relief had to be tackled.

"It is an international problem. The figures of patients who suffer moderate to severe pain after surgery are largely similar to what they were in the 1950s. We have not got further forward.''

The hospital now gives smaller, more regular doses of drugs to reduce pain levels or lets patients take control by using a computerised system to administer drugs at the touch of a button. It automatically cuts off if they try to give themselves too much.

Medics are also using other methods to tackle the pain issue. Epidurals, which are usually associated with childbirth, are now increasingly being used in general surgery.

Surgeon Nick Scott, director of the pain management service at the private HCI International Medical Centre near Glasgow, uses them for patients undergoing major heart or abdominal operations.

Epidurals are basically cocktails of painkillers which are injected into the space around the spinal chord to provide a local anaesthetic. They can be used in any operation below the neck to block the body's stress responses.

"Surgery is like dropping a big boulder into a calm pond. There are big waves for the first few days and then it becomes still again. If you keep the epidural going beyond that, when it is removed the patient just has minor pain,'' says Dr Scott.

"We are trying to take the pain of heart surgery or major abdominal surgery and get the body to think it is no more than a cut finger.''