A Survey to Evaluate the Knowledge and Attitude of Anesthesiology Resident Doctors towards Perioperative Pain Assessment in Children.

Background: Pain assessment in children is often inconsistent despite its recognition as the "fifth vital sign." Untreated perioperative pain has adverse physiological and psychological effects. Although validated tools exist, their use in clinical practice remains limited. This survey evaluated the knowledge of anesthesiology residents towards pediatric pain assessment. Materials and Methods: A prospective, cross-sectional survey was conducted using a validated 15-item questionnaire (Cronbach's α = 0.82). The study was approved by the Institutional Review Board and registered with the Clinical Trial Registry of India (CTRI/2023/06/053717). The questionnaire was distributed electronically to anesthesiology residents (6 months-6 years of anesthesia experience, including ≥3 months in pediatric anesthesia) across teaching hospitals in North India. Results: Of 480 surveys circulated, 210 (43.7%) were returned. While 183 (87.1%) respondents reported awareness of pediatric pain assessment tools, knowledge was incomplete. Only 47% identified that the Face, Legs, Activity, Cry, Consolability scale is not a self-report tool. Most (85.7%) recognized that tool selection depends on age, cognition, and institutional protocols, but only 27.1% correctly noted that observational measures are inappropriate in older children capable of self-reporting. Just 24.3% knew that facial expressions are the most studied behavioral indicator of neonatal pain. Although 90% acknowledged the importance of documentation, responses indicated a gap between theoretical awareness and practical application. Conclusion: Anesthesiology residents possess partial but insufficient knowledge of pediatric pain assessment. Standardized training and institutional adoption of validated tools are needed to bridge the knowledge-practice gap and improve perioperative pain management in children.