Opinions remain divided on the best form of post-operative analgesia following lower abdominal surgery, with an even split between those favouring epidural anaesthesia versus patient-controlled intravenous infusion. Many variations and combinations have attempted to refine and unify these two techniques without clear-cut success. In Sweden, one group has spent several years pioneering intra-abdominal local anaesthetic infusion delivered via intraperitoneal catheters. Talking about their latest paper introducing a patient-controlled bolus version of this technique is Dr Davide Perniola. Dr Perniola reviews the evolution of intra-abdominal local anaesthesia for post-operative pain, its efficacy and potential benefits. Dr Perniola goes on to describe the results of the randomised controlled trial carried in this issue of the BJA, and the several mechanisms by which intra-abdominal bupivicaine may provide impressive post-operative analgesia.