• Patient's evaluation of their ability to mobilise post-operatively. Assessed hourly during the first 6 hours. If the patient is still receiving study treatment, assessments will be made at hours 8, 12, 24, 48, 72 hours & when deem Fit For Discharge [ Time Frame: The primary efficacy endpoint is the patient's ability to mobilise assessed using three validated questions assessed at time of study treatment discontinuation. ] [ Designated as safety issue: No ]
  

• Patient's Pain Rating, Nurse Ease of Care, Patient Global Assessment of Method of Pain Control, Fitness for Discharge, Actual Discharge Time, PCA Use, Anti Emetic Use, Non-opioid Analgesic Use and Suspected Technical Failures [ Time Frame: Patient Global Assessment of Method of Pain Control,assessed at the end of treatment; Fitness for Discharge, PCA Use, Anti Emetic use, non-opioid analgesic, suspected technical failures assessed throughout; Nurse ease of care; use of rescue medication. ] [ Designated as safety issue: No ]
  

This is a randomised (study medication assigned by chance), multicentre, open-label, active-controlled, parallel group study. Approximately 200 patients with expected acute moderate to severe post operative pain after an elective major abdominal (abdominal hysterectomy) or orthopaedic surgery (unilateral primary total hip arthroplasty) will be included. Eligible patients will be randomised to receive either Ionsys or morphine IV PCA. The primary effectiveness endpoint is the patient's ability to mobilise assessed using three validated questions at the time of study treatment discontinuation. This will be summarised by treatment group at each time point post dose, with the assessment at the time of study treatment discontinuation analysed as detailed below. The difference in mobility between the two treatment groups will be assessed using an Analysis of Covariance (ANCOVA) adjusted for the indication (type of surgery). Treatment difference will be presented with a 95 percent confidence interval. The secondary endpoints will be: Ability to mobilise by surgery type; Pain intensity measured on an 11-point scale; Time to fitness for discharge; time to final discharge; Nurse Ease Of Care questionnaire; Patient global assessment of method of pain control; use of post-operative non-opioid analgesics; use of post-operative antiemetics; use of rescue morphine. Patient safety will be assessed using vital signs, adverse events, concomitant medications and non routine events. Ionsys(iontophoretic transdermal system), delivers 40 mcg fentanyl per on-demand dose up to a maximum of 240 mg (6 doses each of 10 minutes duration) per hour but not more than a maximum of 80 doses within a 24-hour period. A new system will be applied every 24 hours, if required. If the patient has used 80 doses in less than 24 hours a new system can be applied earlier. Morphine IV PCA: Morphine bolus doses will be delivered as per local standard of care. Treatment duration will be 24-72 hours.