Postoperative pain trajectories and associated factors in patients undergoing lung cancer surgery: a scoping review.

OBJECTIVES: This scoping review aimed to map the available evidence on postoperative pain trajectories and associated factors in patients undergoing lung cancer surgery and to inform precision pain management in clinical practice. METHODS: PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, CNKI, Wanfang, VIP, and the China Biology Medicine database (CBM) were searched from inception to January 31, 2026. Eligible studies were screened, charted, and narratively synthesized. RESULTS: Eleven studies were included, reporting 35 study-specific trajectory classes, with two to four classes identified per study. These trajectories could be broadly grouped into trajectories based on pain intensity and recovery outcomes, trajectories based on pain threshold changes, and trajectories characterized by pain context or special patterns of evolution. Fourteen assessment tools were identified and classified into five categories: pain measurement instruments, generic pain scales, pain-specific scales, psychological and emotional scales, and sleep-related scales. Associated factors clustered into four domains: physiological, surgery-related, analgesic, and cognitive-psychological factors. CONCLUSION: Postoperative pain trajectories following lung cancer surgery are heterogeneous and study-specific. Future studies should standardize trajectory measurement and reporting, externally validate risk-stratification approaches, and prospectively evaluate the clinical effectiveness of trajectory-informed care. SYSTEMATIC REVIEW REGISTRATION: https://archive.org/details/osf-registrations-s6u7q-v1.