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Published on: January 27, 2010
Methods of Assessing Postoperative Pain in Infants (0-12 Months): A Scoping Review
Jeewan Jyoti1,2, Donna Waters1, Sharon Laing2
1Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia.
Insights
Assessing postoperative pain in infants is challenging due to their nonverbal nature. Current pain assessment methods lack consistency and validation, highlighting the need for improved strategies and family involvement.
Area of Science:
- Pediatric Surgery
- Pain Management
- Clinical Assessment
Background:
- Infants undergoing surgery experience significant postoperative pain.
- Accurate pain assessment in nonverbal infants is crucial for effective management and preventing adverse outcomes.
- Existing pain assessment methods present challenges for clinicians and parents.
Purpose of the Study:
- To map pain assessment methods for postoperative pain in infants (0-12 months).
- To describe the psychometric properties of identified pain assessment tools.
- To identify gaps in current pain assessment practices for infants.
Main Methods:
- A scoping review guided by Arksey and O'Malley's framework.
- Searched Embase, Medline, PsycINFO, Scopus, Cochrane, CINAHL (Jan 2014-Mar 2026).
- Included 35 studies: 4 systematic reviews, 8 trials, 23 original research studies.
Main Results:
- Identified 20 different pain assessment methods used by clinicians.
- Observed inconsistent pain categorization, documentation, and discordance with treatment decisions.
- Found no studies on formal parental pain assessment methods; many tools lacked validation for infants.
Conclusions:
- Current postoperative pain assessment in infants is inconsistent and lacks standardization.
- A multidimensional approach is needed, incorporating continuous monitoring and family involvement.
- Further research is warranted to develop and validate robust infant pain assessment tools.
Abstract:
Infants undergoing surgery experience postoperative pain beyond acute short-lasting procedural pain and have variable analgesic needs. Assessing pain in this nonverbal population presents challenges for clinicians and parents. Given the short- and long-term effects of pain and its treatment, timely and accurate assessment of pain is vital. The aim of this scoping review was to map pain assessment methods used by clinicians and parents to assess postoperative pain in infants aged 0 to 12 months and describe their psychometric properties. The review was guided by Arksey and O'Malley's (2005) five-stage framework. We searched Embase, Medline, PsycINFO, Scopus, Cochrane, CINAHL from January 2014 to March 2026 to retrieve eligible studies. Thirty-five studies (four systematic reviews, eight trials, and 23 original research studies) were included. We identified 20 different pain assessment methods used by clinicians. Postoperative pain categorization was inconsistent and lacked clear differentiation. There were inconsistencies in the duration, frequency, and documentation of pain scores. Several studies highlighted a discordance between pain scores, clinical judgment, and treatment decisions. Some tools had been used without being validated for postoperative pain or the age group studied. We found no studies of formal pain assessment methods used by parents. Observational subjectivity, the lack of current validity testing and standardization in methods, together with the multi-faceted nature of pain reflects the need for a multidimensional approach to assess pain. Research is warranted on continuous monitoring of postoperative pain in infants and family involvement in pain assessment.
