Conference Coverage

Interview Study Maps Biopsychosocial Factors in Postoperative Pain at ≥65

Edited by:
Brian McCurdy

Key Highlights

  • Participants described biological, psychological, and social contributors to pain during the first postoperative week.
  • Themes specific to acute postoperative pain included uncertainty about its course and the need for physical assistance alongside emotional support.
  • Researchers adapted an existing chronic pain framework into a model for acute postoperative pain in older adults.

Older adults described acute postoperative pain as an experience shaped by biological, psychological, and social factors in a qualitative interview study. Investigators incorporated these findings into a Biopsychosocial Model of Acute Postoperative Pain for Older Adults, identifying both similarities to chronic pain and features specific to surgical recovery.

The findings are scheduled for presentation on October 18 at the ANESTHESIOLOGY Annual Meeting 2026 in San Diego. Researchers sought to describe factors that could inform development of nonpharmacologic interventions, citing concerns about medication side effects in older adults.

Investigators interviewed patients aged ≥65 years who underwent major noncardiac surgery about their pain experiences during the first postoperative week. The study described these experiences as an initial step toward intervention development.

The analysis used an abductive approach, beginning with Miaskowski’s Biopsychosocial Model of Chronic Pain for Older Adults. Researchers then adapted that framework to acute postoperative pain through an iterative process involving data familiarization, deductive coding, inductive code generation, and theory development.

Study Findings

Researchers interviewed 15 participants with a median age of 68 years (range: 65–84 years). Women accounted for 53.3% of participants, 33.3% were Black, and 40% underwent elective procedures. Participants identified biological, psychological, and social contributors to their pain experiences, which investigators integrated into the proposed acute postoperative pain model.

The authors reported that depression, anxiety, and stress, along with culture, ageism, and social support, influenced acute pain experiences as they do chronic pain. Distinct acute-setting themes included physical manifestations of injury affecting pain, anxiety arising from uncertainty about the pain course, and a need for physical social support in addition to emotional support. These factors influenced participants’ pain-management goals and coping mechanisms.

Clinical Implications

According to the investigators, many components of the chronic pain biopsychosocial framework also apply to acute postoperative pain. However, the themes emerging from these interviews distinguish the acute setting and highlight psychological and social needs during recovery.

The authors emphasized studying biopsychosocial approaches to develop acute pain care models that incorporate these needs, particularly for older adults at high risk of medication side effects.

Expert Commentary

“Acute pain is not solely a biological process, but psychological and social factors impact the pain experience and patients’ approaches to pain management,” the researchers concluded.

Reference

Samost-Williams A, Huynh JP, Hutcheson K, et al. Redefining recovery: a biopsychosocial model for acute postoperative pain in older adults. Abstract scheduled for presentation at: Anesthesiology 2026; October 16–20, 2026; San Diego, CA. Abstract A1433.