Remote Assessment of Pain and Recovery Quality After Surgery Using a Digital Form: A Pilot Study

Postoperative recovery is a dynamic process requiring continuous monitoring. After discharge from the post-anesthesia care unit (PACU), patients are typically assessed only through periodic in-person visits by the ward staff, which can create gaps in surveillance and lead to underreporting of pain, nausea, and other symptoms during the immediate postoperative period. Digital tools have been proposed as a way to narrow this gap by allowing patients to report symptoms directly and continuously, potentially enabling earlier identification of complications and more timely clinical response.

Despite promising results from international studies on postoperative digital monitoring, reviews have identified important gaps, including methodological heterogeneity, a lack of standardized and validated instruments, and limited integration with clinical teams. There is a particular scarcity of studies evaluating simple, accessible digital tools for the immediate postoperative period in Brazilian public hospitals.

This pilot study was designed to address that gap by testing a simplified, purpose-built digital form for remote postoperative follow-up. During the pre-anesthetic evaluation, patients (or an accompanying caregiver, when needed) are given a link, sent via WhatsApp, to a web-responsive online questionnaire designed for ease of use among postoperative patients. The form includes 18 questions covering pain at rest and during movement, nausea and vomiting, use of rescue analgesics and antiemetics, need for anesthesiology team intervention, functional recovery (ability to urinate and defecate), and overall satisfaction with the recovery process and with the questionnaire itself. Patients are asked to complete the form at two time points: 12 and 24 hours after PACU discharge.

The study's central hypothesis is that a simplified digital form is a feasible and well-accepted tool for remote postoperative monitoring, and that it can capture clinically meaningful data on pain, adverse effects, and perceived recovery. Findings from this pilot are intended to inform the future development of digital follow-up protocols - including potential integration with electronic medical records - for postoperative care in Brazilian public hospital settings, and to identify barriers to more equitable implementation of remote monitoring tools.

Inclusion criteria

• Age ≥ 18 years
• Undergoing elective surgery with anticipated discharge from the post-anesthesia care unit (PACU) to the ward
• Access to a smartphone with internet connection (personally, or through an accompanying caregiver)
• Cognitive capacity to respond to the digital form, or availability of a caregiver to respond on the patient's behalf
• Signed Informed Consent Form

Exclusion criteria

• Anticipated postoperative admission to the intensive care unit (ICU)
• Inability to communicate, with no caregiver available to assist
• Refusal to participate or to use the digital tool
• No access to a mobile device/internet during the first 24 postoperative hours, with no logistical alternative available
• Clinical condition that, at the discretion of the assisting team, contraindicates participation