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Published on: January 27, 2010
Chronic postsurgical pain in children: prevalence and risk factors. A prospective observational study
H Batoz1, F Semjen2, M Bordes-Demolis2
1CHU de Bordeaux, Service d'Anesthésie Pédiatrique, Hôpital Pellegrin, Place Amélie Raba Léon, F-33076 Bordeaux, France helene.batoz@chu-bordeaux.fr.
Insights
Chronic postsurgical pain (CPSP) affects 10.9% of children, often with neuropathic origins. Key risk factors include pre-existing pain and severe acute pain post-surgery, highlighting the need for perioperative pain management.
Area of Science:
- Pediatric Pain Management
- Surgical Outcomes Research
- Epidemiology of Pain
Background:
- Chronic postsurgical pain (CPSP) is prevalent in adults (10-50%), but its epidemiology in children is understudied.
- This study addresses the knowledge gap regarding CPSP prevalence in pediatric populations.
Purpose of the Study:
- To prospectively evaluate the prevalence of chronic postsurgical pain (CPSP) in children.
- To identify risk factors associated with CPSP development in pediatric patients.
Main Methods:
- Prospective observational study including 291 children aged 6-18 years.
- Data collected via preoperative and postoperative questionnaires, including pain history, anxiety, and acute pain scores (VAS).
- Exclusion criteria: ambulatory surgery, refusal, inability to understand, change of address.
Main Results:
- The prevalence of CPSP was 10.9% in 258 children who completed the study.
- Neuropathic pain was the most common type (64.3%).
- Risk factors identified: recent pre-surgical pain (<1 month) and severe acute post-operative pain (VAS >30 mm) after orthopedic and thoracic surgeries.
Conclusions:
- Effective perioperative pain evaluation and treatment are crucial for preventing CPSP in children.
- Early identification and management of risk factors can mitigate long-term pain outcomes.
Background:
Chronic postsurgical pain (CPSP) is well known in adults, with prevalence rates ranging from 10 to 50%. Little is known about the epidemiology of CPSP in children. The aim of this prospective observational study was to evaluate the prevalence of CPSP after surgery in children.
Methods:
After informed consent, children aged six to18 yr were included. Characteristics and risk factors for CPSP were recorded. Exclusion criteria included ambulatory surgery, refusal, inability to understand and change of address. All eligible children completed a preoperative questionnaire the day before surgery about pain, anxiety and their medical history. All data concerning anaesthetic and surgical procedures, such as acute pain scores (VAS) during the first 24 h were recorded. Three months after surgery all included children were sent a postoperative questionnaire about pain at the surgical site.
Results:
Altogether, 291 children were enrolled; the mean age was 12 yr, most subjects were male (60%). The most common type of surgery was orthopaedic (63%). In the 258 patients who completed the study, the prevalence of CPSP was 10.9%, most often with a neuropathic origin (64.3%). The two main risk factors were the existence of recent pain before surgery (<1 month) and the severity of acute postoperative pain (VAS >30 mm) in the first 24 h after orthopaedic and thoracic surgeries. Six months after surgery, only five children needed a visit with a chronic pain practitioner.
Conclusions:
These results highlight the necessity of evaluating and treating perioperative pain in order to prevent CPSP in children.
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