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    Patent Pending

    Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) for Post-Op Pediatric Pain

    Quantifies pain post-operatively in pediatric patients 1-5 years old.


    One can also use the Behavioral Observational Pain Scale (BOPS) for Post-Op Pediatric Pain as an alternative to the CHEOPS.
    When to Use

    Children in the post-operative period.

    Allows for standardized assessment of post-operative pain in children.


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    Creator Insights


    The CHEOPS is widely trusted in post-operative settings.


    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

    Scores ≥5: Consider analgesia.

    Definitions of criteria in the CHEOPS:

    Criteria Score Definition
    No cry +1 Child is not crying.
    Moaning +2 Child is moaning or quietly vocalizing silent cry.
    Crying +2 Child is crying, but the cry is gentle or whimpering.
    Scream +3 Child is in a full-lunged cry; sobbing; may be scored with complaint or without complaint.
    Smiling 0 Score only if definite positive facial expression.
    Composed +1 Neutral facial expression.
    Grimace +2 Score only if definite negative facial expression.
    Child Verbal
    Positive 0 Child makes any positive statement or talks about others things without complaint.
    None +1 Child not talking.
    Other complaints +1 Child complains, but not about pain, e.g., 'I want to see mommy' of 'I am thirsty'.
    Pain complaints +2 Child complains about pain
    Both complaints +2 Child complains about pain and about other things, e.g., 'It hurts; I want my mommy'.
    Neutral +1 Body (not limbs) is at rest; torso is inactive.
    Shifting +2 Body is in motion in a shifting or serpentine fashion.
    Tense +2 Body is arched or rigid.
    Shivering +2 Body is shuddering or shaking involuntarily.
    Upright +2 Child is in a vertical or upright position.
    Restrained +2 Body is restrained.
    Not touching +1 Child is not touching or grabbing at wound.
    Reach +2 Child is reaching for but not touching wound.
    Touch +2 Child is gently touching wound or wound area.
    Grab +2 Child is gently touching wound or wound area.
    Reastrained +2 Child is grabbing vigorously at wound.
    Neutral +1 Legs may be in any position but are relaxed; includes gentle swimming or separate-like movements.
    Squirm/kicking +2 Definitive uneasy or restless movements in the legs and/or striking out with foot or feet.
    Drawnup/tensed +2 Legs tensed and/or pulled up tightly to body and kept there.
    Standing +2 Standing, crouching or kneeling.
    Restrained +2 Child's legs are being held down.
    Dr. Patrick J. McGrath

    About the Creator

    Patrick J. McGrath, MD, is a professor of clinical psychiatry at Columbia University. He is currently co-director of the Depression Evaluation Service at the New York State Psychiatric Institute. Dr. McGrath’s current research focus is on pharmacogenetics and radiological imaging of brains to determine potential genetic response to antidepressant medications.

    To view Dr. Patrick J. McGrath's publications, visit PubMed