Predictors of Postoperative Pain Trajectories in Adolescent Idiopathic Scoliosis

Abstract

3.

Remembering pain after surgery

“…Children were eligible if they were between the ages of 10–18 years and undergoing either spinal fusion or pectus repair surgeries. Spinal fusion and pectus repair were chosen based on prior literature showing that children undergoing these surgeries are at risk for experiencing acute and persistent post-surgical pain [17; 38; 29; 27; 34; 10]. …”

Trajectories of postsurgical pain in children

“…Emerging research indicates that many of these children have problems with pain after hospital discharge [21], with 80% of children experiencing moderate-severe pain at home two weeks after major surgery. Furthermore, recent studies suggest that pain may persist long-term for a sizeable portion of these children, with around 20% of children reporting significant pain beyond the expected healing period after major surgeries [4,7,17]. In the short-term, postsurgical pain significantly impacts children’s recovery from surgery.…”

“…While rates of persistent pain have been measured in a few studies in children 6 to 12 months after surgery [4,17], understanding of the course of postsurgical pain over time is limited. In adult populations, extensive research has examined the persistence of postsurgical pain [11,12] and recent research has identified distinct trajectory patterns in pain recovery after surgery [18].…”

“…Based on recent adult studies [18], we hypothesized that a subgroup of children would follow a trajectory characterized by slower recovery of pain. Based on perioperative studies in children suggesting that child psychological factors [4] and parental factors [16] play a role in pain persistence, we hypothesized that greater child and parental pain catastrophizing would be associated with a late recovery trajectory. Finally we hypothesized that membership in a late pain recovery trajectory group would be associated with poorer HRQOL, and greater activity limitations over long-term.…”

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

“…CPSP studies in children are limited with a preliminary incidence of CPSP reported as 13-25% [77][78][79][80]. Prospective studies after spine surgery have also demonstrated prevalence rates of CPSP between 11 and 22% with risk factor for development of CPSP including high levels baseline pain intensity, anxiety and older age [81][82][83]. Recently, Rabbitts et al found two distinct pain trajectories following major surgery in children; most children follow a positive early recovery pathway, whereas 22% follow a late recovery trajectory.…”