He lived in London during the plague, and also had surgery at a time when it wasn't quite performed the same way as it is today. Instead of being given anesthesia, he was held down.
I'm curious about the shape of the scar on a patient who had to be forcibly restrained, but I doubt either he or the doctor cared.
I didn't finish the diary as a fan of Mr. Pepy's, but still, the guy had a lot of strength to be able to get on a table and agree to surgery without anesthesia.
Another book I read explained that they did have laudanum or some type of painkiller before modern anesthesia but said that it lowered respiration on the patients. Doctors preferred not to use it. Something about it being better to have a screaming live patient than an eternally quiet one.