Abstract / Summary
Chronic post-surgical pain is a prevalent and often preventable complication of surgery in children and youth, which contributes to functional impairment, psychological distress, and leads to substantial costs to families and the healthcare system. There is no national standard or clinical guideline to date that aims to prevent or reduce the incidence of chronic post-surgical pain following pediatric surgery. The purpose of this capstone was to conduct a narrative literature review to identify the core components needed to develop a perioperative pain care pathway that reduces the incidence of chronic post-surgical pain in the pediatric population. Fifteen publications were selected through a structured search and screening process and were synthesized using the biopsychosocial model of pain as a guiding framework. Core components identified included early risk screening and stratification, psychological optimization, patient and family education, improvement of physical function, multimodal opioid-sparing pain management, and coordinated multidisciplinary care through a transitional pain service. The synthesis also revealed an inconsistency in how chronic post-surgical pain was defined, measured, and compared across research studies, which limited the generalizability of findings. It was concluded that a structured perioperative pathway should include a continuum of biopsychosocial care delivered across the preoperative, intraoperative, and postoperative phases. A key recommendation identified was the implementation of universal risk screening for all children and youth undergoing surgery by using validated measurement tools such as the Pediatric Pain Screening Tool. Additionally, testing a proposed sample perioperative pain pathway is recommended before broader implementation and dissemination.