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The problem of controlling postoperative pain is acute at approximately three to eight hours following the injection of the local anesthetic. In the unpremedicated patient, the prescription of strong analgesic agents to provide maximum pain control during this critical period will usually be indicated in all but the patients classified as 'easy' impactions. Postoperative pain and trismus appear to be closely related. Control of postoperative pain will usually aid in the control of postoperative trismus. Swelling frequently reaches its peak at approximately 36 hours postoperatively. The value of ice applications in the control of postoperative swelling is debatable. Surgical difficulty and postoperative pain experience are related when dealing with 'difficult' versus 'easy' impactions. Approximately 25% of patients with easy impactions will experience moderate or severe pain within three hours following surgery when postoperative care is withheld. This figure rises to 50% of the patients with impactions classified as 'difficult.' Adequate intravenous premedication obviates the need for routine prescription of narcotics to control postoperative pain. Only 23% of patients with intravenous premedication experienced postoperative pain of a degree to warrant the use of strong analgesic agents. Objective determinations of serum free 17-hydroxycorticosteroid levels indicate that stress in impaction surgery is related to surgical difficulty and that the patient's response can be beneficially affected by an intensive regimen of postoperative care. (Author)