1. Re: Persistent Pain following Common Outpatient Surgeries in Children: A Multicenter Study in Italy
- Author
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Bruno Guido Locatelli, Karen Boretsky, Valeria Mossetti, Roberta Nicoletti, Valter Sonzogni, Micol Maffioletti, Rodolfo Lio, Marinella Astuto, Noemi Vicchio, Giorgio Ivani, and David Zurakowski
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,Activities of daily living ,Adolescent ,Urology ,medicine.medical_treatment ,Hernia, Inguinal ,Pacu ,03 medical and health sciences ,0302 clinical medicine ,Anesthesia, Conduction ,Risk Factors ,030202 anesthesiology ,Surveys and Questionnaires ,Prevalence ,medicine ,Humans ,Orchiopexy ,Longitudinal Studies ,Prospective Studies ,Child ,Herniorrhaphy ,Pain Measurement ,Pain, Postoperative ,biology ,business.industry ,Persistent pain ,Infant ,biology.organism_classification ,Anesthesiology and Pain Medicine ,Multicenter study ,Ambulatory Surgical Procedures ,Italy ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Ambulatory ,Orthopedic surgery ,Female ,Observational study ,Chronic Pain ,Pediatric anesthesia ,business ,030217 neurology & neurosurgery - Abstract
Introduction The prevalence of persistent postsurgical pain in children is over 20% after major surgeries; however, data are scarce on the prevalence, character, and risk factors among children undergoing common ambulatory surgeries. The primary aim of this study was to evaluate the prevalence of persistent pain following pediatric ambulatory surgery at 1, 3, and 6 months. Secondary aims were to identify risk factors and characterize the pain and consequences of persistent postsurgical pain. Methods ASA I-II, ages 1 month to 16 years old, undergoing elective hypospadias repair, herniorraphy, orchiopexy, and orthopedic surgery were enrolled in a prospective, longitudinal, observational study at 3 pediatric centers in Italy. All patients received general plus regional anesthesia. Postoperative pain was evaluated using age appropriate pain scales at 1 and 3 hours. At 1, 3, and 6 months, pain scores were obtained and Parent's Postoperative Pain Measures ( 8 yo) surveys were administered. Results About 350 patients completed the study. The prevalence of pain at 1, 3, and 6 months was 24% (84/350), 6.0% (21/350), and 4.0% (14/350), respectively. Inguinal herniorraphy patients experienced significantly higher pain at all 3-time points; 35.6%, 14.9%, and 9.2%. There was no significant association between mean pain scores >4 in PACU and persistent pain. Pain persisting at 6 months had neuropathic characteristics and frequently interfered with daily activities and sleep. Conclusion Our data support the presence of persistent pain in pediatric patients after common surgeries. Most patients who developed persistent pain at 6 months had pain at 1 month. We recommend questioning at follow-up visit about persistent pain and functional impairment with follow-up until resolution.
- Published
- 2018