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Updated: Jul 28, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Risk and protective factors in predicting pediatric acute postsurgical pain: A systematic review and meta-analysis
Cheryl H T Chow1, Christy Yu2, Wei Yu2
1Department of Psychology, Neuroscience & Behaviour, McMaster University.
Insights
Acute postsurgical pain (APSP) in children is influenced by preoperative pain, anxiety, and catastrophizing. Enhancing coping strategies can help mitigate this pain, improving recovery after surgery.
Area of Science:
- Pediatric Surgery
- Pain Management
- Psychosocial Factors
Background:
- Acute postsurgical pain (APSP) affects most pediatric surgical patients, with many experiencing pain that disrupts daily life.
- Identifying factors influencing APSP is crucial for effective pain management strategies.
Conclusions:
- While identified factors show some association with APSP, further research is needed to explain the variability in pain experiences.
- Early identification of at-risk pediatric patients is essential for timely intervention to minimize pain burden.
- Interventions focused on enhancing child coping mechanisms may effectively reduce APSP.
Objective:
Acute postsurgical pain (APSP), defined as pain within 3 months after surgery, is reported in most surgical pediatric patients, and a significant number of patients experience pain interfering with their daily life activities. We aimed to identify perioperative and psychosocial factors associated with APSP severity in pediatric patients undergoing surgery.
Method:
MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and CENTRAL were searched from database inception to October 2021. Studies that reported an association between risk or protective factors and acute pain in children were included. The primary outcome was the magnitude of association between identified factors and APSP, as measured by standardized effect sizes.
Results:
Thirty-eight studies (7,936 participants aged 1-18 years) were included. Meta-analysis of 12 studies (1,192 participants) revealed child preoperative pain, pain immediately after surgery, anticipated pain, temperament, pain catastrophizing, age, preoperative anxiety, parent pain catastrophizing, and parent preoperative anxiety were positively associated with APSP. Child pain coping efficacy was protective against APSP. We identified several modifiable child and parent psychosocial factors as predictors of APSP severity.
Conclusion:
Given the small degree of association between identified factors and postsurgical pain, there is value in pursuing other factors that may better explain the variability in pain. Recognizing patients at risk for moderate to severe APSP enables early implementation of interventions to minimize pain burden. Interventions to enhance coping, an adaptive characteristic, may also help to reduce APSP. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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