5 requires comfort measures; >10 requires analgesia dose adjustment# Pain causes stress. The endocrine system reacts by releasing an excessive amount of hormones, ultimately resulting in carbohydrate, protein, and fat catabolism (destruction); poor glucose use; and other harmful effects. This reaction combined with inflammatory processes can produce weight loss, tachycardia, increased respiratory rate, fever, shock, and death. Unrelieved pain prolongs the stress response, adversely affecting the patient's recovery.> Cardiovascular system responds to stress of pain by activating the sympathetic nervous system, which produces a variety of unwanted effects.> In the postoperative period, these include hypercoagulation and increased heart rate, blood pressure, cardiac work load, and oxygen demand.> Aggressive pain control is required to reduce these effects and prevent thromboembolic complications.> Cardiac morbidity is the primary cause of death after anesthesia and surgery">