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. 2026 Feb 26.
doi: 10.1111/anae.70180. Online ahead of print.

Using peri-operative patient- and parent-reported experience and outcome measures to identify paediatric postsurgical recovery trajectories: an observational cohort study

Samantha Pang  1 , Nicholas West  1 , Haoyu Zhao  2 , Jessica Luo  1 , Neil K Chadha  1   3 , Lynnie R Correll  1   4 , Heng Gan  1   4 , Matthias Görges  1   4
Affiliations

Using peri-operative patient- and parent-reported experience and outcome measures to identify paediatric postsurgical recovery trajectories: an observational cohort study

Samantha Pang et al. Anaesthesia. .

Abstract

Introduction: Identifying postoperative pain trajectories and pre-operative risk factors may support preventative measures and enhance pain management. We aimed to determine the feasibility of gathering peri-operative data from families of children, describe their recovery trajectories and identify risk factors for high postsurgical pain.

Methods: Peri-operative data were collected from patients aged 0-18 y. A pre-operative survey collected demographic, physical, psychosocial and family factors. Postoperative outcome surveys were sent at several postoperative time points. Growth mixture modelling established discrete trajectories for average and worst pain intensity. Relationships between pre-operative factors and postoperative pain trajectories were explored using multinomial logistic regression.

Results: The survey was completed for 444 patients. Median (IQR [range]) age was 9 (4-14 [0-18]) y, 34.5% were female. Follow-up retention was > 65% up to postoperative day 30 for patients < 5 y and up to postoperative day 15 for patients > 5 y. Recovery trajectories revealed non-zero pain scores up to postoperative day 90. Pre-operative risk factors for a high average pain trajectory included: age 13-18 y (OR 5.9, 95%CI 3.1-11.5, p < 0.001); female sex (OR 2.1, 95%CI 1.3-3.3, p = 0.002); orthopaedic surgery (OR 4.1, 95%CI 1.7-10.4, p = 0.002); anxiety (OR 2.0, 95%CI 1.1-3.5, p = 0.017); depression (OR 2.1, 95%CI 1.2-3.6, p = 0.007); previous emotional trauma (OR 2.5, 95%CI 1.5-4.3, p = 0.001); analgesic use > 7 days before surgery (OR 3.4, 95%CI 1.8-6.8, p < 0.001); and parental chronic pain (OR 4.1, 95%CI 1.6-12.7, p = 0.007).

Discussion: Collecting longitudinal postoperative recovery data from adolescents and parents of children is feasible and may improve the understanding of pain and recovery trajectories. This study identifies patient, parental and surgical factors associated with a higher likelihood of a high pain trajectory.

Keywords: paediatric anaesthesia; pain trajectories; patient‐reported outcomes; postoperative pain; postoperative recovery.

Plain language summary

What we did: We collected information from families of children and teenagers (aged 0 to 18 years) who were having surgery. Before the operation, families filled in a survey about things like health, feelings, and family life. After the operation, we sent more surveys to ask about how much pain the children had while they recovered. We used this information to group children by how their pain changed over time.

Why did we do it: Some children have more pain after surgery than others. We wanted to find out: how long pain lasts after surgery; and which children are more likely to have a lot of pain. This could help doctors and nurses give better pain care in the future.

What we found: We found that many children still had some pain weeks or even months after surgery. Teenagers were more likely to have high levels of pain than younger children. Girls were more likely to have worse pain than boys. Children who felt anxious or depressed before surgery were more likely to have worse pain. Children who had emotional trauma before were also more likely to have worse pain. Children who used pain medicine for more than a week before surgery had more pain after surgery. Children were more likely to have worse pain if their parent had long‐lasting pain. This means that a child's feelings, past experiences and family situation can affect how much pain they feel after surgery.

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References

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