re at all times,' the essay will use a pseudonym when discussing the patient.
             Martin, a 51 year old gentleman suffering from rectal carcinoma was admitted to the ward for an abdominoperineal resection. This is a major surgical procedure involving the removal of the end portion of the large colon and the entire rectum and anus, the resulting large rectal cavity is closed together with sutures. The end of the remaining colon is brought to the surface and used to form a stoma through a surgical opening in the lower abdomen for faeces to pass through, the faeces is collected in a colostomy bag. Martin gave his consent for the author to accompany him to theatre and observe the operation.
             Alexander, Fawcett and Runcimann, (2000) indicate that a patients pain should be controlled before they leave the recovery room. Davis (2000) suggests that in surgical intervention pain involved can to a large be anticipated and planned for. In most cases there should be little or no pain experienced. Modern techniques of assessment, monitoring and administration should ensure that the minimum of pain is suffered. Plans for Martin's pain control were implemented upon arrival in the anaesthetic room prior to his surgery. The anaesthetist sited an epidural for post operative analgesia to be administered via an IVAC pump, (epidural infusion analgesia). Epidural is described by Davis (2000) as a fine catheter sited into the epidural space of the spinal column. The administration of a continuous weak solution of opioids and local anaesthetic via this route blocks nerves as they enter the spinal cord and is an effective method of pain relief (Carroll and Bowsher, 1996). Following surgery Martin spent 2 days on the high dependency unit before returning to the surgical ward, the epidural was still in situ for pain relief.
             The numerical verbal rating score assessment tool for pain is the preferred and most widely used pain tool of the ho...