The assessment of pain intensity after surgery is important for guiding pain management. Due to the limitations of current pain evaluation tools, there is increasing interest in using objective methods to assess pain in clinical settings. This literature review aims to provide an overview of physiological methods for postoperative pain evaluation. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed to perform a literature search on the Scopus database from 2002 to March 2024. Sixty-one studies were included in this review investigating parameters derived from six physiological signals, including Electrocardiogram (ECG), Photoplethysmogram (PPG), Skin Conductance (SC), Electroencephalogram (EEG), Electromyogram (EMG), and pupil size and reflexes. Parameters extracted from ECG, PPG, and SC signals were the most commonly studied. While there is evidence to support the use of physiological parameters as measures for postoperative pain evaluation, further research is needed to establish the reliability and generalizability of these parameters to develop an indicator that can be consistently applied across various clinical settings. For this purpose, this review describes current research findings and identifies limitations and directions for future work that should be considered in upcoming research on postoperative pain assessment.
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