Paediatrics · Anaesthesiology

Behavioral Observational Pain Scale (BOPS) for Post-Op Pediatric Pain calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Facial expression

Score each behaviour 0, 1 or 2 by observation. The total is 0 to 6.

Verbalization

Body position

Result

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Primary source

Hesselgard K, Larsson S, Romner B, Strömblad LG, Reinstrup P. Validity and reliability of the Behavioural Observational Pain Scale for postoperative pain measurement in children 1-7 years of age. Pediatr Crit Care Med. 2007;8(2):102-108. DOI: 10.1097/01.PCC.0000257098.32268.AA. PMID: 17273124. The scale scores three behaviours: facial expression, verbalization and body position. The scoring table (Figure 1 of the first author's Lund University thesis, which contains this validation study) scores each 0, 1 or 2. Face: 0 neutral or positive (smiling, composed), 1 negative facial expression and/or concerned, 2 negative facial expression (grimace, distorted). Verbalization: 0 normal conversation (laugh, crow), 1 completely quiet or sobbing and/or complaining but not because of pain, 2 crying, screaming and/or complains about pain. Body position: 0 inactive, lying relaxed with all extremities, or sitting, walking; 1 restless movements, shifting fashion and/or touching wound or wound area; 2 lying rigid and/or drawn up with arms and legs to the body. The sum is 0 to 6, and a score above 2 should lead to pain relief treatment when other causes such as fear, discomfort or parent separation are not apparent. (2007)

Scope: Children aged 1 to 7 years after surgery, scored by observation. It does not separate pain from fear, discomfort or separation distress.

Last reviewed 2026-10-18

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Hesselgard K, Larsson S, Romner B, Strömblad LG, Reinstrup P. Validity and reliability of the Behavioural Observational Pain Scale for postoperative pain measurement in children 1-7 years of age. Pediatr Crit Care Med. 2007;8(2):102-108. DOI: 10.1097/01.PCC.0000257098.32268.AA. PMID: 17273124. The scale scores three behaviours: facial expression, verbalization and body position. The scoring table (Figure 1 of the first author's Lund University thesis, which contains this validation study) scores each 0, 1 or 2. Face: 0 neutral or positive (smiling, composed), 1 negative facial expression and/or concerned, 2 negative facial expression (grimace, distorted). Verbalization: 0 normal conversation (laugh, crow), 1 completely quiet or sobbing and/or complaining but not because of pain, 2 crying, screaming and/or complains about pain. Body position: 0 inactive, lying relaxed with all extremities, or sitting, walking; 1 restless movements, shifting fashion and/or touching wound or wound area; 2 lying rigid and/or drawn up with arms and legs to the body. The sum is 0 to 6, and a score above 2 should lead to pain relief treatment when other causes such as fear, discomfort or parent separation are not apparent. (2007)

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Clinical inputs

Facial expression
Verbalization
Body position

Primary source

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