Pain After Brachial Plexus Injury Surgery: Variability in Reporting

Pain is a major contributor to morbidity following brachial plexus injury (BPI), yet pain-related outcomes are inconsistently reported. The extent of postoperative pain improvement after surgical reconstruction remains unclear due to variable measurement techniques and nonstandardized reporting intervals. A systematic review was conducted in accordance with the PRISMA guidelines. Studies involving adults undergoing operative treatment for traumatic BPI that reported pain using the Visual Analog Scale (VAS) were included. Data extraction focused on the timing and methods of postoperative pain assessment. Nine studies met the inclusion criteria. Pain reporting demonstrated substantial heterogeneity, with more than 15 different postoperative timepoints reported across studies. Only a small minority of studies reported pain at comparable intervals, precluding pooled analysis. Pain was consistently prevalent after BPI, particularly in cases involving root avulsion, and several surgical techniques were associated with qualitative pain improvement. Overall, pain reporting after BPI surgery lacks standardization, limiting meaningful comparison of outcomes. Standardized measurement intervals and reporting methods are needed to guide clinical expectations and strengthen future research.