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The efficacy of 0.25% bupivacaine as a pre-emptive analgesic agent was evaluated in a prospective case control study - a group of patients undergoing elective orthognathic surgery against a matched control group. Bupivacaine was administered as a series of nerve blocks prior to the incision for the surgery. Outcome variables measured were postoperative pain by Visual Analogue Scale (VAS) score, need and amount of rescue analgesics and the incidence of known complications associated with these agents. The VAS score was significantly lower in the group receiving pre-emptive analgesia for upto 40 hours postoperatively, (P< 0.05). The amount of rescue analgesics administered and the incidence of complications attributed were less in study group than that of the control group, (P>0.05). Bupivacaine can be used for pre-emptive analgesia in oral and maxillofacial surgery.