In this review, the definition and history of preemptive analgesia and the progress of its conception will be summarized. In the physiology-pathophysiology chapter, central sensitization, the key component of the evolution of postoperative pain, and the neurochemical processes in its background will be explored. Tissue damage caused by surgical incision consists of mechanical and inflammatory components, and it has high importance in the postoperative pain management. The preemptive approach of pain management means more than just preincisional analgesia, it includes the application of multifactious synergistic medication at the same time accordingly. All of these knowledges finally became complete in the conception of the perioperative approach of preventive pain management, which covers the premedication and mental support of a patient in the preoperative setting, furthermore consumes the whole armamentarium of the preemptive (preoperative), intraoperative and postoperative analgesia regimen as well. In practice, procedure-specific pain management should be highlighted, since it is based on the different extents and types of tissue trauma caused by various operations. Orv Hetil. 2018; 159(17): 655-660.