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Despite decades of research and the availability of effective analgesic approaches, many patients continue to experience moderate to severe pain after surgery. Greater research efforts are needed to identify the factors that impede effective pain management. Despite the fact that a variety of research and clinical studies on all aspects of pain have been conducted in many countries, the factors affecting pain management have not been completely identified. Aim: To identify nurses’ experiences and perceptions about the barriers to postoperative pain management. Methods: A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 26 Iranian registered nurses from three large educational hospitals in Tehran city. The data were analysed using constant comparative method. Findings: Ninety-three primary codes were achieved. Four main themes emerged from the data. From the participants’ points of view, ‘lack of educational preparation’, ‘nurses’ limited authority’, ‘limited nurse-patient relationship’, and ‘disturbances in pain management interventions’ are considered barriers to pain management. Conclusion: The conclusion embraces implications for clinical practice to improve the knowledge of nurses and nursing manager and insight in postoperative pain management. Clearly, programmes for change must address not only knowledge improvement, but also the wider complex influences on barriers to pain management. Published by arrangement with John Wiley & Sons.

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