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Updated: Jun 25, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 28, 2010
A prospective observational study on persistent postoperative pediatric pain, 4P: The study protocol
Johanna Broman1,2, Niklas Nielsen1,2, Anna K M Persson3,4
1Department of Anesthesiology and Intensive Care, Helsingborg Lasarett, Helsingborg, Sweden.
Insights
This study estimates the incidence of acute and persistent postoperative pain in children. It also examines adherence to European guidelines for pediatric pain management.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Outcomes
Background:
- Adequate pain treatment is a child's right, yet many experience acute and persistent pain.
- Limited data exists on the occurrence of both acute and persistent pain in pediatric populations.
- Persistent postoperative pain in children is understudied but significantly impacts daily life.
Purpose of the Study:
- To estimate the incidence of acute and persistent postoperative pain in children.
- To evaluate adherence to European Society for Paediatric Anaesthesiology guidelines.
- To identify risk factors for pediatric postoperative pain.
Main Methods:
- Prospective observational study (4P) of 1000 children aged 1-17 in southern Sweden.
- Data collection on preoperative pain, analgesia, and perioperative management.
- Postoperative pain evaluation at 24h, 3, 6, and 12 months via electronic software.
Main Results:
- The study will provide incidence rates for acute postoperative pain (APOP) and persistent postoperative pain (PPOP).
- It will assess current pain treatment regimens and their effectiveness.
- Risk factors contributing to APOP and PPOP will be identified.
Conclusions:
- The 4P study will offer crucial insights into pediatric postoperative pain.
- Findings will inform clinical practice and guideline adherence for better pain management.
- This research aims to reduce the burden of pain in children undergoing surgery.
Background:
Access to adequate pain treatment is a fundamental right, yet international data suggest that a considerable number of children experience acute and persistent pain. Little is known about the occurrence of both acute and persistent pain in children. The incidence of persistent postoperative pain in children is an unexplored area but international studies suggest that many children experience long-term pain after surgery, with a major impact on daily life. In 4P, Persistent Postoperative Pediatric Pain, we want to estimate the incidence of acute and persistent postoperative pediatric pain. The European Society for Paediatric Anaesthesiology has developed guidelines for perioperative pain management. We aim to examine how well these guidelines are followed and whether adherence to guidelines influences the pain experienced after surgery.
Method:
4P is a prospective observational study of children aged 1-17, planned for surgery in southern Sweden 2023-2024. After agreement from all caregivers, data concerning preoperative pain, pre-emptive analgesia, perioperative management and postoperative pain will be collected. Via an electronic management software, pain will be evaluated at home (or in hospital) at 24h, 3, 6 and 12 months after surgery. We will include 1000 patients.
Discussion:
4P will prospectively follow a large number of children after general pediatric surgeries and evaluate the occurrence of postoperative pain, both acute (APOP) and persistent (PPOP). The study will assess pain treatment regimens and identify risk factors associated with the development of acute and persistent pediatric postoperative pain.
Trial Registration:
Prospectively posted at ClinicalTrials.gov, identifier NCT06035042.
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