Elsevier

Journal of Pediatric Surgery

Volume 46, Issue 9, September 2011, Pages 1700-1705
Journal of Pediatric Surgery

Original article
Acute to chronic postoperative pain in children: preliminary findings☆

https://doi.org/10.1016/j.jpedsurg.2011.03.074Get rights and content

Abstract

Background/purpose

Chronic postoperative pain is a well-established clinical phenomenon that is associated with adverse outcomes. The incidence of this clinical phenomenon in children, however, is not well established. The purpose of this study was to identify the incidence of chronic pain in children after surgery.

Methods

Following a screening process, a total of 113 children and their parents were enrolled in this cross-sectional study. Data regarding persistence and characteristics of pain after surgery were obtained.

Results

Approximately 13% of the children, most of whom underwent orthopedic procedures, reported the existence of symptoms of chronic postoperative pain. Most of the children indicated that the pain started immediately after surgery, was localized to the surgery site, and was intermittent. Children reported a median duration of pain of 4.1 months, and approximately half of the children experienced pain most days of the week. Up to 30% of the children reported interference of pain in functioning in areas such as extracurricular activities and sleep.

Discussion

Given the large number of children at risk for experiencing chronic postoperative pain, preventative efforts are necessary. Large-scale cohort prospective studies are needed to confirm the results of this cross-sectional study.

Section snippets

Participants

Participants in this study included a cohort of children 2 to 17 years old who underwent general anesthesia and surgery at Children's Hospital of Orange County from December 2008 to October 2009. Inclusion criteria included children undergoing general surgery, orthopedic surgery, and urologic surgery. Children were excluded for the following circumstances: American Society of Anesthesiologists (ASA) physical status classification III or IV, any procedure associated with cancer (eg, biopsy),

Sample description

A total of 113 children and their parents were enrolled in this study from 16 different surgeons (average number of cases per surgeon, 7.1 ± 4.3). On average, children and parents were interviewed 9 months after the child's surgery (SD, 4.17), with a range of time between surgery and interview of 3 to 18 months. Average age of children who completed the survey was 12.4 ± 3.9 years, and most children (69%) were males (please see additional baseline characteristics in Table 1).

Incidence of chronic postoperative pain and baseline characteristics of pain sample

Of the 113

Discussion

Under the conditions of this study, we demonstrated that the phenomenon of chronic postoperative pain does exist in children. In fact, 13% of our study sample of children reported experiencing chronic pain as a result of surgery. Overall, children reported pain that was clinically significant, frequent, and significantly interfered with activities at home, school, and with friends. The surgeries most related to chronic postsurgical pain in this study were orthopedic in nature, although general

Acknowledgment

None of the authors have any financial arrangements or other potential conflicts of interest to disclose.

References (36)

  • E.K. Aasvang et al.

    Pain and functional impairment 6 years after inguinal herniorrhaphy

    Hernia

    (2006)
  • M.F. Maguire et al.

    A questionnaire study investigating the prevalence of the neuropathic component of chronic pain after thoracic surgery

    Eur J Cardiothorac Surg

    (2006)
  • A. Fassoulaki et al.

    Acute postoperative pain predicts chronic pain and long-term analgesic requirements after breast surgery for cancer

    Acta Anaesthesiol Belg

    (2008)
  • O.J. Vilholm et al.

    The postmastectomy pain syndrome: an epidemiological study on the prevalence of chronic pain after surgery for breast cancer

    Br J Cancer

    (2008)
  • L. Nikolajsen et al.

    Phantom limb pain

    Curr Rev Pain

    (2000)
  • L. Nikolajsen et al.

    Chronic pain following caesarian section

    Acta Anaesthesiol Scand

    (2004)
  • J.A. Hunfeld et al.

    Chronic pain and its impact on quality of life in adolescents and their families

    J Pediatr Psychol

    (2001)
  • K. Midence

    The effects of chronic illness on children and their families: an overview

    Genet Soc Gen Psychol Monogr

    (1994)

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    ☆

    No funding was received for this study.

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