Arch Gynecol Obstet (2009) 279:771–774 DOI 10.1007/s00404-009-0938-y 123 SHORT COMMUNICATION Who’s asking? Patients may under-report postoperative pain scores to nurses (or over-report to surgeons) following surgery of the female reproductive tract Eric Scott Sills · Marc G. Genton · Anthony P. H. Walsh · Salim A. Wehbe Received: 3 December 2008 / Accepted: 6 January 2009 / Published online: 17 January 2009  Springer-Verlag 2009 Abstract Objective To determine if postoperative pain reporting via standardised visual analogue scale (VAS) is aVected by which member of the healthcare team collects the information. Materials and methods A standardised ten-point VAS measured postsurgical pain level among patients (n = 60) undergoing laparotomy via Pfannenstiel incision. All study patients received the same patient-controlled analgesia and uniform post-operative orders were used. VAS data were gathered from patients by surgeons (MD) and nurses (RN) 6 h and 24 h after surgery; RNs and MDs independently recorded patients’ VAS pain scores in variable order. Results When assessed 6 h after surgery, the average pain level reported by patients to RNs was signiWcantly lower than that reported to MDs (3.3 § 2.8 vs. 4.0 § 2.4; P = 0.02). Average patient pain levels remained lower when reported to RNs 24 h post-operatively compared to that reported to MDs, although this diVerence was not signiWcant (1.9 § 2.1 vs. 2.1 § 2.1; P = 0.39). Whenever post-surgical patients provided diVerent VAS scores for pain level to RNs and MDs, the higher pain reading was always reported to the MD. Conclusion This study identiWed important variances in subjective pain reporting by patients that appeared to be inXuenced by who sampled the data. We found patients gave lower VAS pain scores to RNs compared to MDs; the reverse pattern was never observed. Post-surgical patients may communicate pain information diVerently depending on who asks them, particularly in the early post-operative period. Accordingly, patient pain data gathered over time by a care team with a heterogeneous composition (i.e., RNs, MDs) may not be fully interchangeable. Patient projections of pain severity and/or intensity appear to vary as a function of who evaluates the patient. Keywords Post-operative pain · Visual analogue scale · Nurse · Surgeon · Discordance Introduction EVective relief from acute pain after surgery minimises stress and contributes greatly to a positive overall hospital experience. This key objective relies on all members of the care team working together and acting on the basis of accu- rate information. At the centre of this dynamic is the patient, although it is not known whether patients regard nurses and surgeons in the same way when communicating the intensity of pain following surgery. When considering how to measure a patient’s post-surgical pain intensity, could it depend on who is asking? To study this, our inves- tigation prospectively compared pain scores expressed by E. S. Sills (&) · A. P. H. Walsh The Sims Institute/Sims International Fertility Clinic, Rosemount Hall, Rosemount Estate, Dundrum Road, Dundrum, Dublin 14, Ireland e-mail: drscottsills@sims.ie E. S. Sills · A. P. H. Walsh Department of Obstetrics and Gynaecology, School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland M. G. Genton Department of Econometrics, University of Geneva, Geneva, Switzerland S. A. Wehbe Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA