Predictive Factors of Acute Pain After Day Surgery: A Meta-Analysis

Hanqing Zhang,1,2 Xinglian Gao1 1Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of ChinaCorrespondence: Xinglian Gao, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, People’s Republic of China, Email [email protected]: This study aims to provide evidence-based recommendations for optimizing postoperative pain management and enhancing recovery efficiency by identifying key predictors of acute postoperative pain in day surgery patients.Background: As day surgery becomes more widespread, effective management of acute postoperative pain is crucial for successful recovery. A variety of studies have explored factors influencing postoperative acute pain. This study synthesizes existing evidence through a meta-analysis to clarify the primary predictors.Methods: A comprehensive search was performed across multiple databases, including PubMed, CINAHL, Scopus, Web of Science, EMBASE, the Cochrane Library, and CNKI, to identify clinical studies examining factors associated with acute postoperative pain following day surgery. The search encompassed all relevant publications up to January 30, 2025. The systematic review and meta-analysis employed a fixed-effects model to analyze the data, with a random-effects model applied in cases of significant heterogeneity.Results: Ten studies involving 11,865 patients were included. Significant predictors of acute postoperative pain, including: insufficient use of analgesics (OR = 2.12, P < 0.00001), age < 45 years (OR = 2.88, P < 0.00001), open surgery (OR = 5.05, P < 0.00001), education level ≤ middle school (OR = 2.06, P = 0.0001), preoperative fear and anxiety (OR = 2.18, P < 0.00001), higher preoperative pain expectation (OR = 1.74, P < 0.00001), and general anesthesia (OR = 1.91, P < 0.0001).Conclusion: This study identified the main predictors of acute postoperative pain in day surgery, suggesting these factors should be incorporated into clinical assessments to optimize pain management and recovery. The main risk factors include analgesic usage, age, surgery type, education level, preoperative fear and anxiety, pain expectation, and anesthesia type. Effective preoperative management of these factors may reduce postoperative pain and enhance recovery.Keywords: day surgery, predictive factors, meta-analysis, postoperative acute pain