SynthesisBMJ open2019
Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 198 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Open-Label Randomized Controlled Trial to Assess Preoperative Acupuncture for Patients Undergoing Total Knee or Hip Arthroplasty
Total Shoulder Arthroplasty Preoperative Pain Threshold Prospective
Adolescent Surgery Roadmap Feasibility and Acceptability Study
Effect of Perioperative Use of Dexmedetomidine-esketamine Combination on Incidence of Moderate-to-severe Pain After Spinal Surgery: a Randomized Controlled Trial
Effect of Perioperative Use of Dexmedetomidine-esketamine Combination on Incidence of Chronic Postsurgical Pain After Spinal Surgery: a Randomized Controlled Trial
Who cites it
198 citing papers in PubMed, 4 syntheses or guidelines pooled it, 389 citations in OpenAlex.
- Postoperative Pain Management After Lumbar Discectomy. A Systematic Review With Meta-Analyses and Trial Sequential Analyses.European journal of pain (London, England) · 2026Pooled it
- Prolonged opioid use after surgery in children, adolescents, and young adults: a systematic review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Pooled it
- Systematic review/meta-analysis on the role of CB1R regulation in sleep-wake cycle in rats.Journal of evidence-based medicine · 2024Pooled it
- Comparison of bilateral to unilateral total extra-peritoneal (TEP) inguinal hernia repair: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2023Pooled it
- Effect of intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing laparotomy for gynecologic malignancy: a randomized controlled trial.International journal of surgery (London, England) · 2026Trial
- Optimising Treatment Expectations Using a Video-Based Intervention in Orthopaedic Surgery: Results From a Randomised Controlled Trial.European journal of pain (London, England) · 2025Trial
- Addition of Liposomal Bupivacaine to Standard Bupivacaine versus Standard Bupivacaine Alone in the Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial.Anesthesiology · 2024Trial
- Opioid requirement and pain intensity after mandibular surgeries with dexmedetomidine administration in two ways: intraoperative infusion versus bolus injection.Oral and maxillofacial surgery · 2024Trial
- Trial
- S-Ketamine Improves Slow Wave Sleep and the Associated Changes in Serum Protein Among Gynecological Abdominal Surgery Patients: A Randomized Controlled Trial.Nature and science of sleep · 2023Trial
- Ultrasound-Guided Quadratus Lumborum Block Enhances the Quality of Recovery after Gastrointestinal Surgery: A Randomized Controlled Trial.Pain research & management · 2022Trial
- Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients.BMC anesthesiology · 2021Trial
- Development and Validation of a Clinical Prediction Rule to Identify Preoperatively Patients With Acute Refractory Pain After Lumbar Spine Surgery.Pain practice : the official journal of World Institute of Pain · 2026Article
- Acute Pain During Intensive Care: Prevalence, Predisposing Factors and Pain Trajectories. A Prospective Multicenter Observational Study.Acta anaesthesiologica Scandinavica · 2026Observational
- Preoperative Risk Factors for Opioid Use Predict Self-Reported Health and Function Up to 6 Months After Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2026Article
- Does individual pain threshold influence postoperative pain after connective tissue graft surgery?Clinical oral investigations · 2026Article
- Poor postoperative pain control is associated with prolonged length of stay after elective spine surgery: An observational cohort study.North American Spine Society journal · 2026Article
- Narrow intercostal anatomy is associated with early postoperative pain after thoracoscopic surgery.Surgery today · 2026Article
- Personalized Prediction of Acute and Chronic Postsurgical Pain - the role of Multidomain Biosignatures, Machine Learning-Based Integration, and Standardized Outcome Definitions.Current pain and headache reports · 2026Review
- The effect of preoperative fear and anxiety on postoperative pain in surgical patients: a descriptive and correlational study.Irish journal of medical science · 2026Article
138 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesInadequate postoperative pain control is common and is associated with poor clinical outcomes. This study aimed to identify preoperative predictors of poor postoperative pain control in adults undergoing inpatient surgery.
designSystematic review and meta-analysis DATA SOURCES: MEDLINE, Embase, CINAHL and PsycINFO were searched through October 2017. ELIGIBILITY CRITERIA: Studies in any language were included if they evaluated postoperative pain using a validated instrument in adults (≥18 years) and reported a measure of association between poor postoperative pain control (defined by study authors) and at least one preoperative predictor during the hospital stay. DATA EXTRACTION AND SYNTHESIS: Two reviewers screened articles, extracted data and assessed study quality. Measures of association for each preoperative predictor were pooled using random effects models.
resultsThirty-three studies representing 53 362 patients were included in this review. Significant preoperative predictors of poor postoperative pain control included younger age (OR 1.18 [95% CI 1.05 to 1.32], number of studies, n=14), female sex (OR 1.29 [95% CI 1.17 to 1.43], n=20), smoking (OR 1.33 [95% CI 1.09 to 1.61], n=9), history of depressive symptoms (OR 1.71 [95% CI 1.32 to 2.22], n=8), history of anxiety symptoms (OR 1.22 [95% CI 1.09 to 1.36], n=10), sleep difficulties (OR 2.32 [95% CI 1.46 to 3.69], n=2), higher body mass index (OR 1.02 [95% CI 1.01 to 1.03], n=2), presence of preoperative pain (OR 1.21 [95% CI 1.10 to 1.32], n=13) and use of preoperative analgesia (OR 1.54 [95% CI 1.18 to 2.03], n=6). Pain catastrophising, American Society of Anesthesiologists status, chronic pain, marital status, socioeconomic status, education, surgical history, preoperative pressure pain tolerance and orthopaedic surgery (vs abdominal surgery) were not associated with increased odds of poor pain control. Study quality was generally high, although appropriate blinding of predictor during outcome ascertainment was often limited.
conclusionsNine predictors of poor postoperative pain control were identified. These should be recognised as potentially important factors when developing discipline-specific clinical care pathways to improve pain outcomes and to guide future surgical pain research. PROSPERO REGISTRATION NUMBER: CRD42017080682.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.