Pooled proportion and associated factors of postoperative pain during the recovery time among adult surgical patients in an Ethiopian setting with limited resources: A Systematic review and Meta-analysis

Abstract

Introduction Postoperative pain is an acute condition caused by tissue injury sustained during surgical treatments. Untreated postoperative pain has various repercussions, including extended hospital stays, chronic pain, respiratory infection, myocardial infarction, atelectasis, increased risk of thromboembolic events, anxiety, sleep disruptions, and even death. This study aimed to investigate the pooled proportion and determinants of acute postoperative pain among adult surgical patients. Methods The PubMed, Web of Science, Scopus, EMBASE, CINHAL, and Cochrane Library databases were searched. Data extraction was conducted via Microsoft Excel, and STATA version 17 was used for analysis. Publication bias was assessed using funnel plots and Egger and Begg regression tests. Heterogeneity was evaluated using the I² statistic. A random-effects model was used to calculate pooled proportions and odds ratios with 95% confidence intervals. Results Thirteen studies with 3,381 participants were included. The pooled prevalence of postoperative pain among adult surgical patients was 64.3% (95% CI: 53.5–75.0), with substantial heterogeneity (I² = 82.94%). Preoperative pain (AOR = 4.44, 95% CI: 1.68–7.21), preoperative anxiety (AOR = 2.58, 95% CI: 1.54–3.62), and duration of surgery >45 minutes (AOR = 2.11, 95% CI: 1.09–3.12) were significantly associated with higher odds of postoperative pain. Age (AOR = 0.96, 95% CI: 0.29–1.63) and previous history of surgery (AOR = 1.59, 95% CI: 0.35–2.82) were not significantly associated, as their confidence intervals crossed the null value. Conclusion This systematic review and meta-analysis reveals a high pooled prevalence of postoperative pain in Ethiopia, although the estimate varies widely across studies. Identified determinants highlight potential targets for improved clinical assessment and management. Future research should standardize pain assessment tools and reporting time points to allow better pooling across studies