[The sympathetic system and chronic pain in pediatrics]

Sympathetic dystrophy is defined as continuous pain in a portion of an extremity after trauma not involving a major nerve. It may be exacerbated by movement, physiotherapy or stress. There are sympathetically mediated changes with initial vasodilatation and if untreated progress to a second dystrophic stage. In 2 years 48 patients (7-17 years) were evaluated and treated by the same protocol. For the majority of cases the time from the start of pain until the time of treatment was less than 60 days. The treatment was always performed by technical procedures: i.v. regional guanethidine, long-term epidural catheter or lumbar sympathetic blocks. In case of chronic pain the role of sympathic nervous system must be debatable and it is absolutely necessary to perform a treatment such as it is not a simple technic but always a safe technic.