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CHEOPS — Post-op Pain (1–7 years)

Children's Hospital of Eastern Ontario Pain Scale for post-operative pain. Range 4-13.

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1 What is the CHEOPS — Post-op Pain (1–7 years)?

The CHEOPS — Post-op Pain (1–7 years) is a pain scoring tool used in paediatric practice. Children's Hospital of Eastern Ontario Pain Scale for post-operative pain. Range 4-13. It scores 6 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in pain
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 6 criteria: Cry; Facial; Verbal; Torso; Touch; Legs. Totals are then banded: 4 points or more - No / minimal pain: cHEOPS 4-6 - minimal pain. Continue observation; 7 points or more - Analgesia indicated: cHEOPS ≥7 - analgesia is indicated. Treat and reassess in 15-20 minutes; 10 points or more - Significant pain: cHEOPS 10-13 - significant pain. Give prompt analgesia and review the analgesic plan.
  • Minimum score is 4 (not 0) because several items score from 1.
  • Source: McGrath PJ et al. CHEOPS: a behavioral scale for rating postoperative pain in children. Adv Pain Res Ther 1985;9:395-402.

4 Frequently asked questions

How many criteria does the CHEOPS — Post-op Pain (1–7 years) use?

6. They are Cry; Facial; Verbal; Torso; Touch; Legs.

What do the bands of the CHEOPS — Post-op Pain (1–7 years) mean?

The total is interpreted as: 4 points or more - No / minimal pain: cHEOPS 4-6 - minimal pain. Continue observation; 7 points or more - Analgesia indicated: cHEOPS ≥7 - analgesia is indicated. Treat and reassess in 15-20 minutes; 10 points or more - Significant pain: cHEOPS 10-13 - significant pain. Give prompt analgesia and review the analgesic plan.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Minimum score is 4 (not 0) because several items score from 1.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

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For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.