BACKGROUND: In addition to the analgesic selection and method of administration, how medical and nursing staff perceives postoperative pain and opioid analgesia is important for the effective pain control. Therefore, we have studied about these perceptions of our medical and nursing staff. METHODS: Eighty five surgeons and seventy eight registered nurses working in the surgical wards within this hospital were surveyed by means of questionnaires to identify the attitudes to postoperative pain and knowledge about opioid analgesia. RESULTS: Seventy-nine percent of doctors and 61% of nurses attempted to relieve pain as much as possible. However, 47% of the nurses felt that analgesia was under-prescribed. The reasons given to administer analgesics inadequately by the doctors and nurses were side effects such as emesis, respiratory depression, and the fear of drug addiction. Regarding respiratory depression, 47% of doctors and 60% of nurses felt it occurred after i.m. injection of opioids postoperatively. Concerning the possibility of addiction after the patients were given 50~100 mg demerol i.m. every four hours for one week after major surgery; 37% of doctors and 83% of nurses thought that drug addiction may develop. CONCLUSIONS: Our medical and nursing staff personnel were afraid of respiratory depression as well as a fear of addiction when they administered opioids. This situation is likely to be a significant factor in under-prescribing. It may be necessary for them to have a special education program about pain relief and opioid analgesia after surgery.