Optimizing postoperative pain management in children: evidence, pitfalls, and practical recommendations

A substantial proportion of children experience moderate to severe pain following routine surgical procedures. Despite increasing awareness, pediatric postoperative pain remains frequently underestimated and inadequately treated. This review integrates current evidence with expert opinion on potentials pitfalls to provide practical recommendations aimed to improve postoperative pain management in children. Key strategies include the routine use of regional anesthesia when feasible, scheduled administration of two classes of non-opioid analgesics, integration of non-pharmacological interventions, and regular pain assessment to guide treatment adjustments. The importance of pediatric pain registries is highlighted to track clinical practice and drive quality improvement. Additionally, we propose that transitional pain services offer a valuable framework for implementing preventive strategies and individualized coaching, thereby supporting improved long-term outcomes in the pediatric surgical population.