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    Behavioral Observational Pain Scale (BOPS) for Post-Op Pediatric Pain

    Quantifies post-operative pain for children aged 1-7 years.


    This pain scale is for use in patients 1-7 years old.

    One can also use the Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) for Post-Op Pediatric Pain as an alternative to the BOPS.
    When to Use

    Children after undergoing surgery.

    Allows for simple, quick pain assessment in children 1-7 years old after surgery.

    Neutral/positive facial expression, composed, calm
    Negative facial expression, concerned
    Negative facial expression, grimace, distorted face
    Normal conversation, laugh, crow
    Completely quiet, sobbing and/or complaining but not because of pain
    Crying, screaming and/or complaining about pain
    Inactive, laying, relaxed with all extremities or sitting, walking
    Restless movements, shifting fashion and/or touching wound or wound area
    Lying rigid and/or drawn up with arms and legs to the body


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    Next Steps
    Creator Insights


    The BOPS is easy to use when assessing pediatric pain.

    Critical Actions

    The BOPS requires close and attentive clinical evaluation of facial expressions, vocalization and body language.


    Addition of selected points.

    Facts & Figures

    Pain assessments should be performed:

    • Every 3 hours
    • 15-20 minutes after IV administration of analgesics
    • 30-45 minutes after oral/rectal administration

    Consider analgesia for scores ≥ 3.

    Dr. Kanwaljeet J.S. Anand

    About the Creator

    Kanwaljeet J.S. Anand, MD, PhD, is a professor of medicine in the department of pediatrics at the University of Tennessee Health Science Center. He is also a professor of anatomy and neurobiology. His research focuses on pain management and treatment disorders, specifically in pediatric patients.

    To view Dr. Kanwaljeet J.S. Anand's publications, visit PubMed

    About the Creator
    Dr. Kanwaljeet J.S. Anand