Evidence map›Paper›PMID 39909544›Full record

SynthesisRegional anesthesia and pain medicine2025

Prognostic factors of chronic postsurgical pain in children and adolescents: a systematic review and meta-analysis.

Brittany N Rosenbloom, Simona Denise Frederiksen, Vienna Wang, Christine S Park, Grace Gordon, Gurpreet Brar, Nivez Rasic, Jennifer N Stinson, Kathryn A Birnie, Jennifer A Rabbitts

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Regional anesthesia and pain medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Observational
  5. Observational
  6. Postoperative pain management in children.Frontiers in pediatrics · 2026
    Review
  7. Article
  8. Review
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Brittany N RosenbloomToronto Academic Pain Medicine Institute, Women's College Hospital, Toronto, Ontario, Canada brittany.rosenbloom@wchospital.ca.
Simona Denise FrederiksenAlberta Health Services Health Systems Evaluation and Evidence, Edmonton, Alberta, Canada.
Vienna WangDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Christine S ParkDentistry, University of Washington, Seattle, Washington, USA.
Grace GordonCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
Gurpreet BrarAlberta Health Services Health Systems Evaluation and Evidence, Calgary, Alberta, Canada.
Nivez RasicDepartment of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada.
Jennifer N StinsonThe Hospital for Sick Children Child Health Evaluative Sciences, Toronto, Ontario, Canada.
Kathryn A BirnieDepartment of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada.
Jennifer A RabbittsStanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-5881-4045

Funding

Preventing the Transition from Acute to Chronic Musculoskeletal Pain in Adolescents after Surgery: The Role of SleepK24AR080786 · NIAMS · STANFORD UNIVERSITY · PI Jennifer Rabbitts · 2023 to 2026
$712k
NIAMS NIH HHS K24 AR080786
6 · The paper itself

Abstract

backgroundApproximately 28% of children and adolescents undergoing major surgery develop chronic postsurgical pain (CPSP; pain persisting>3 months). A previous review attempted to investigate biopsychosocial prognostic factors for pediatric CPSP; however, due to lack of data, no meta-analytic techniques were employed. Since that review, numerous studies have investigated risk/protective factors that fall within an Interpersonal Fear Avoidance Model for CPSP, thus warranting a reinvestigation of prognostic factors.

objectiveThis systematic review and meta-analysis aimed to examine prognostic factors, measurement tools applied, and their effect on the development of CPSP. EVIDENCE REVIEW: Prospective, observational studies examining prognostic factors of pediatric CPSP using validated self-report measures were included. 4884 unique publications were screened and 15 met inclusion criteria.

findingsThe pooled effect size for the association between presurgical child pain intensity and the presence of child CPSP was significant, OR=0.540 (95% CI=0.184 to 0.894). Child anxiety, child pain-related anxiety, and parent pain catastrophizing were not significant prognostic factors for child CPSP. Using Grading of Recommendations, Assessment, Development, and Evaluation, the certainty in prognostic estimates was moderate. Risk of bias using Quality in Prognostic Study tool ranged from low to moderate.

conclusionsPresurgical pain was the only presurgical risk factor at the meta-analytic level that significantly predicted pediatric CPSP, highlighting the importance of prioritizing pain management throughout the perioperative experience, starting before surgery. Depressive symptoms and sleep disturbance were the two potential risk/protective factors that were unable to be assessed due to insufficient data or use of an unvalidated measure indicating a critical need for future research. PROSPERO REGISTRATION NUMBER: CRD42022306340.

Indexed as

Chronic PainPostoperative PainAdolescentChildHumansObservational Studies as TopicPain MeasurementPrognosisRisk FactorsAnxietyCHRONIC PAINDepressionMeta-AnalysisPain, Postoperative

Identifiers

PMID39909544
PMCPMC11804872

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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.