Acute postoperative pain: resources

Optimal methods for the use of ‘pain’ as an outcome in systematic reviews of postoperative pain management

Pain is a common primary or secondary outcome in systematic reviews of perioperative anaesthesia and postoperative care. How methods are applied and outcomes are managed varies substantially across published reviews and this can create problems when trying to interpret their findings. Indeed, while it can appear to be simple, managing pain as an outcome presents us with a number of interesting challenges.

At the Cochrane Pain, Palliative and Supportive Care (PaPaS) Review Group we have developed resources to help to guide review authors and people who are using systematic reviews in this field towards optimal methods in this field. This project was supported by a Cochrane Network Innovation Fund, and the resources were developed in consultation with the Cochrane Musculoskeletal, Oral, Skin and Sensory (MOSS) Network and other key contacts in this topic area.

In this project we established an expert group of editors and authors to distil and synthesise evidence-based best practice guidance on the management of pain as an outcome in systematic review of perioperative anaesthesia and postoperative care. We reviewed the evidence to support best practice, elucidated examples, and provide some recommendations and considerations (see resources below). Discussion is presented on areas of uncertainty where further research is needed, how to incorporate this practice into systematic reviews, and on transferable learnings to systematic review practice in general.

You will find a checklist of critical items that authors of reviews in this field should consider when designing and conducting their review. The checklist also serves as a guide to optimal methods for people who are trying to make sense of a systematic review that has postoperative pain as an important outcome. We are also developing a series of short presentations outlining the evidence underpinning the issues covered in the checklist [coming soon].

Through this project our hope is that we have provided resources to drive improvement in the standard of systematic reviews in this field, and also a useful guide for those seeking to use systematic reviews to guide clinical decisions.

Access the resources on our website here. 

For any queries, please contact PaPaS Managing Editor Anna Erskine at