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Updated: Sep 2, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
"Persistent Post-Operative Pain in Children - An Argument for a Transitional Pain Service in Pediatrics"
Natasha Haynes1, Catriona Mclean1, John Collins2
1Department of Pain Medicine, The Children's Hospital at Westmead, Sydney, Australia.
Insights
Persistent post-operative pain in children is common, often neuropathic and following orthopedic surgery. Early intervention with non-pharmacologic strategies and a transitional pain service can improve outcomes for pediatric patients.
Area of Science:
- Pediatric Pain Management
- Post-operative Care
- Pain Medicine
Background:
- Persistent post-operative pain affects pediatric patients despite extensive research on causes.
- Limited literature addresses treatment and prevention, with a focus on specific surgical procedures.
Purpose of the Study:
- Identify risk factors and clinical features of persistent post-operative pain in children.
- Describe pharmacologic and non-pharmacologic management strategies.
- Explore options for improved outcomes, including transitional pain services.
Main Methods:
- Retrospective chart review of 31 pediatric patients with persistent post-operative pain.
- Data collected included demographics, pain characteristics, surgery type, and treatment outcomes.
- Analysis focused on identifying risk factors and management approaches.
Main Results:
- Most cases involved neuropathic pain, commonly after orthopedic surgery.
- Pain resolution was achieved in 27 out of 31 children following the implemented pain management plan.
- Management emphasized early intervention, non-pharmacologic methods, and conservative opioid use.
Conclusions:
- While identifying risk factors is important, proactive prevention strategies are crucial.
- A transitional pain service is recommended for early intervention and implementation of pre- and post-operative pain management strategies.
Background:
Persistent post-operative pain continues to occur in pediatric patients. Despite the growing amount of literature on causes, there is little discussion on treatment and prevention with a majority of studies focusing on specific surgeries.
Aim:
The aim of this retrospective chart study is to identify risk factors and clinical features of persistent post-operative pain after any surgery in a pediatric quaternary complex pain service, describe the pharmacologic and non-pharmacologic management in children, and explore options to improve outcomes, in particular, the introduction of a transitional pain service.
Methods:
A retrospective chart review recorded demographics, gender, age, pain location and surgery type, treatment, and outcomes of 31 children identified through relevant registers over a 2-year period.
Results:
A total of 31 children were positively identified as having persistent post-operative pain and were seen in the complex pain clinic. Consistent with the literature, most cases represented neuropathic pain and persistent post-operative pain was most commonly seen after orthopedic surgery. All but four children had resolution of their pain after implementing the pain management plan. Management was characterized by early intervention, emphasis on non-pharmacologic strategies, and conservative use of opioids.
Conclusions:
Identifying risk factors is useful, however putting strategies into place for prevention is necessary. Early intervention and the implementation of strategies before and immediately after are best provided by a transitional pain service.
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