Does massage during a long operation reduce pain in the recovery period?

INTERVENTION: Intra‐operative passive movements (IPM): The treatment protocol was devised by the hospital's senior physiotherapists using techniques described by Maitland. The movements have been standardised (each movement is to be performed twice) and will take five minutes. The treatment will be administered once during a natural break in surgery and again at the end of surgery before the patients are taken through to the recovery ward. IPM will not interfere with the surgeon and will be well away from where the surgeon is working. Sterility of the surgical field will be ensured at all times. Trained anaesthetic assistants who are responsible for patient positioning along with the anaesthetists and surgeons will carry out the treatment. The anaesthetic assistants will be trained by a named researcher, using a DVD designed specially for this IPM therapy. Control: Control treatment is passive movements of both upper limbs and lower limbs, and is carried out in sequence over a period of 5 minutes. The first treatment is during a natural break (mid‐surgery), and the second is after completion of surgery. The total duration of the treatment is 10 minutes, and follow up will be 24 hours. CONDITION: Non‐surgical site pain ; Signs and Symptoms ; Pain PRIMARY OUTCOME: The mean Visual Analogue Scale (VAS) pain score at 1 hour post‐operatively. SECONDARY OUTCOME: The mean cumulative morphine consumption in 24 hours post‐operatively. INCLUSION CRITERIA: Women over the age of 18 years undergoing delayed deep inferior epigastric perforators (DIEP) and trans‐rectus abdominis muscle (TRAM) breast reconstructive surgery.