This is an updated version of the original Cochrane review published in Issue 1, 1999. Patient surveys have shown that postoperative pain is often not managed well, and there is a need to assess the efficacy and safety of commonly used analgesics as newer treatments become available. Dextropropoxyphene is one example of an opioid analgesic that used to be widely prescribed for pain relief in combination with paracetamol under names such as Co-proxamol and Distalgesic. This drug is now only available on a named patient basis in the UK. For this group there is a provision for the supply of unlicensed co-proxamol on the responsibility of the prescriber.