Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain
Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain
复制标题
DOI：
10.2147/jpr.s40846
复制
发表时间：
2013-01-01
影响因子：
2.7
通讯作者：
Katz, Joel
中科院分区：
文献类型：
--
作者：
Page, M. Gabrielle;Stinson, Jennifer;Katz, Joel
背景资料：本研究的目的是检查小儿慢性术后疼痛（CPSP）在手术后第一年的轨迹，并确定CPSP的急性术后预测因子。83名8-18岁儿童（平均值13.8，标准差2.4）接受大骨科或普外科手术的患者在48-72小时完成疼痛和疼痛相关心理测量，2周（仅疼痛焦虑和疼痛测量），术后6个月和12个月。结果：结果显示，手术后1年，22%的儿童发展为中度至重度CPSP，功能障碍最小。出院后两周内，数字评定量表疼痛强度评分>= 3/10的儿童在6个月时发生中度/重度CPSP的可能性是那些报告数字评定量表疼痛评分3/10的儿童的3倍以上，在12个月时发生中度/重度CPSP的可能性是那些报告数字评定量表疼痛评分3/10的儿童的2倍以上。（6个月相对风险3.3，95%置信区间1.2-9.0和12个月相对风险2.5，95%置信区间0.9-7.5）。疼痛不愉快的预测过渡从急性到中度/重度CPSP，而焦虑敏感性预测的维护中度/重度CPSP从6至12个月后surgery.Conclusions：这项研究突出了儿童CPSP的患病率和心理变量在其发展/维护中发挥的作用。与CPSP发展相关的风险因素与维持CPSP的风险因素不同。
Background: The goals of this study were to examine the trajectory of pediatric chronic postsurgical pain (CPSP) over the first year after surgery and to identify acute postsurgical predictors of CPSP.Methods: Eighty-three children aged 8-18 years (mean 13.8, standard deviation 2.4) who underwent major orthopedic or general surgery completed pain and pain-related psychological measures at 48-72 hours, 2 weeks (pain anxiety and pain measures only), and 6 and 12 months after surgery.Results: Results showed that 1 year after surgery, 22% of children developed moderate to severe CPSP with minimal functional disability. Children who reported a Numeric Rating Scale pain-intensity score >= 3 out of 10 two weeks after discharge were more than three times as likely to develop moderate/severe CPSP at 6 months and more than twice as likely to develop moderate/severe CPSP at 12 months than those who reported a Numeric Rating Scale pain score, 3 (6-month relative risk 3.3, 95% confidence interval 1.2-9.0 and 12-month relative risk 2.5, 95% confidence interval 0.9-7.5). Pain unpleasantness predicted the transition from acute to moderate/severe CPSP, whereas anxiety sensitivity predicted the maintenance of moderate/severe CPSP from 6 to 12 months after surgery.Conclusions: This study highlights the prevalence of pediatric CPSP and the role played by psychological variables in its development/maintenance. Risk factors that are associated with the development of CPSP are different from those that maintain it.