Postoperative pain management satisfaction and its determinants among orthopedic patients in Northwest Ethiopia: a multicenter cross-sectional study

Abstract Postoperative pain is a common and distressing complication following surgery, particularly among orthopedic patients, due to extensive tissue injury and invasive procedures. Poorly managed POP can delay recovery, prolong hospital stays, increase complications, and reduce patient satisfaction. Despite the known burden, evidence on patient satisfaction with postoperative pain management among adult orthopedic patients in Ethiopia remains limited. This study aimed to assess patient satisfaction with postoperative pain management and its associated factors among adult orthopedic surgery patients at comprehensive specialized hospitals in the Amhara region from September 17 to December 13, 2025. A multicenter, institutional-based cross-sectional study was conducted among adult orthopedic surgical patients. A total of 423 participants were recruited using a consecutive sampling technique. Data were collected via semi-structured questionnaires adapted from validated tools and supplemented with locally relevant variables. Descriptive statistics were used to summarize participant characteristics, and bi-variable and multivariable logistic regression analyses were performed to identify factors associated with satisfaction. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine the strength of associations, with p -values < 0.05 considered statistically significant. Among the 423 participants, 79.4% (95% CI 75.30, 83.03) reported satisfaction with postoperative pain management. Factors significantly associated with higher satisfaction included undergoing elective surgery (AOR = 2.92, 95% CI 1.58–5.40), having no or low preoperative anxiety (AOR = 2.98, 95% CI 1.67–5.34), receiving preoperative analgesia (AOR = 2.39, 95% CI 1.29–4.40), shorter surgical duration (≤ 1 h) (AOR = 3.71, 95% CI 1.11–12.37), and use of peripheral nerve block-based postoperative analgesia (AOR = 2.98, 95% CI 1.27–7.02). Patient satisfaction with postoperative pain management was moderately high and significantly associated with several factors, including anxiety, preoperative analgesia, and perioperative practices such as elective surgery, shorter procedures, and the use of peripheral nerve block analgesia. To enhance postoperative pain control and patient satisfaction, healthcare facilities may consider prioritizing preoperative anxiety management, routine preoperative analgesia, and the consistent use of peripheral nerve block-based analgesia. In resource-limited settings, landmark-based techniques with appropriate provider training may support safe and effective implementation.