The goal of this observational pilot study is to evaluate whether video-based visual scenarios representing different levels of pain are preferred over the traditional Numerical Rating Scale (NRS) by postoperative patients. The study also investigates the clarity and interpretability of both methods and examines the level of agreement between the selected video and the reported NRS score.

This prospective, observational, single-center pilot study evaluates the usability and preference of a novel video-based pain expression method compared to the standard Numerical Rating Scale (NRS) in postoperative adult patients. Videos representing 5 different pain intensities (NRS 1-2, 3-4, 5-6, 7-8, 9-10) were created using AI-assisted scenario generation and VEO-3 video production tools. Each video features age- and sex-matched models (male and female in three age categories: 18-44, 45-65, >65 years) demonstrating realistic, simulated pain expressions.

In the recovery unit, patients aged 18 and above will be shown the video series and asked to:

Select the video that best reflects their current pain

Report their pain using the NRS

Indicate which method (video or NRS) they prefer for expressing pain

Indicate which method they found easier to understand

Collected data will include demographic variables, surgical details, comorbidities, and responses to the pain assessment tools. The study will enroll at least 82 participants based on power analysis.

Data will be anonymized and analyzed using descriptive and inferential statistics including Chi-square, Spearman correlation, and p<0.05 significance level.

The planned sample size was amended prior to the enrollment of the first patient, increasing from 120 to 240 participants. This adjustment was made to ensure sufficient statistical power for planned subgroup analyses.

Inclusion Criteria:

• Age ≥ 18 years
• Undergoing any type of surgery
• Admitted to the postoperative recovery unit (PACU) in stable condition
• Able to understand and respond to questions
• Provide written informed consent (ICF)

Exclusion Criteria:

• Age < 18 years
• Refusal or inability to provide informed consent
• Visual impairment or blindness
• Impaired consciousness or cognitive inability to complete the questionnaire
• History of psychiatric illness
• Planned postoperative ICU admission
• Patients undergoing surgery for intracranial mass
• History of seizure disorders

The study population consists of adult postoperative patients (aged 18 years and older) who are recovering in the recovery room following any type of surgery. Participants must be conscious, cooperative, and capable of evaluating and expressing their pain using both video-based scenarios and the Numerical Rating Scale (NRS). All participants will provide written informed consent prior to participation. The population will include a range of age and gender groups to allow evaluation of method preference across demographic subgroups.