OBJECTIVE Acute postsurgical pain (APSP), defined as pain within 3 months after surgery, is reported in most surgical pediatric patients, and a significant number of patients experience pain interfering with their daily life activities. We aimed to identify perioperative and psychosocial factors associated with APSP severity in pediatric patients undergoing surgery. METHOD MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and CENTRAL were searched from database inception to October 2021. Studies that reported an association between risk or protective factors and acute pain in children were included. The primary outcome was the magnitude of association between identified factors and APSP, as measured by standardized effect sizes. RESULTS Thirty-eight studies (7,936 participants aged 1-18 years) were included. Meta-analysis of 12 studies (1,192 participants) revealed child preoperative pain, pain immediately after surgery, anticipated pain, temperament, pain catastrophizing, age, preoperative anxiety, parent pain catastrophizing, and parent preoperative anxiety were positively associated with APSP. Child pain coping efficacy was protective against APSP. We identified several modifiable child and parent psychosocial factors as predictors of APSP severity. CONCLUSION Given the small degree of association between identified factors and postsurgical pain, there is value in pursuing other factors that may better explain the variability in pain. Recognizing patients at risk for moderate to severe APSP enables early implementation of interventions to minimize pain burden. Interventions to enhance coping, an adaptive characteristic, may also help to reduce APSP. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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预测小儿急性术后疼痛的风险和保护因素：系统评价和荟萃分析。

目的 大多数外科儿科患者都会出现急性术后疼痛 (APSP)，定义为术后 3 个月内的疼痛，并且相当多的患者会出现影响日常生活活动的疼痛。我们的目的是确定与接受手术的儿科患者 APSP 严重程度相关的围手术期和心理社会因素。从数据库建立到 2021 年 10 月，对 METHOD MEDLINE、EMBASE、CINAHL、PsycINFO、Web of Science 和 CENTRAL 进行了检索。其中包括报告风险或保护因素与儿童急性疼痛之间存在关联的研究。主要结果是确定的因素与 APSP 之间的关联程度，通过标准化效应大小来衡量。结果 纳入 38 项研究（7,936 名 1-18 岁参与者）。对 12 项研究（1,192 名受试者）的荟萃分析显示，儿童术前疼痛、手术后立即疼痛、预期疼痛、气质、疼痛灾难化、年龄、术前焦虑、父母疼痛灾难化和父母术前焦虑与 APSP 呈正相关。儿童疼痛应对功效对 APSP 具有保护作用。我们确定了一些可改变的儿童和家长心理社会因素作为 APSP 严重程度的预测因素。结论 鉴于已确定的因素与术后疼痛之间的关联程度较小，因此寻找可以更好地解释疼痛变异性的其他因素是有价值的。识别有中度至重度 APSP 风险的患者可以尽早实施干预措施，以最大程度地减少疼痛负担。增强应对（一种适应性特征）的干预措施也可能有助于降低 APSP。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。