From the Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, School of Medicine, Witten, Germany (B.Z., J.W.); German Paediatric Pain Centre, Children's Hospital, Datteln, Germany (B.Z., J.W., H.B., G.H.); University of Applied Sciences, Osnabrück, Germany (G.H.); and Department of Pain Management, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr University Bochum, Bochum, Germany (C.M.).
Anesthesiology. 2015 Mar;122(3):699-707. doi: 10.1097/ALN.0000000000000573.
This review aimed to synthesize the current evidence on the effectiveness of invasive treatments for complex regional pain syndrome in children and adolescents. Studies on children and adolescents with complex regional pain syndrome that evaluated the effects of invasive treatment were identified in PubMed (search March 2013). Thirty-six studies met the inclusion criteria. Articles reported on a total of 173 children and adolescents with complex regional pain syndrome. Generally, many studies lack methodological quality. The invasive treatments applied most often were singular sympathetic blocks, followed by epidural catheters and continuous sympathetic blocks. Rarely, spinal cord stimulation and pain-directed surgeries were reported. An individual patient frequently received more than one invasive procedure. Concerning outcome, for approximately all patients, an improvement in pain and functional disability was reported. However, these outcomes were seldom assessed with validated tools. In conclusion, the evidence level for invasive therapies in the treatment of complex regional pain syndrome in children and adolescents is weak.
本综述旨在综合目前关于儿童和青少年复杂性区域疼痛综合征的侵袭性治疗效果的证据。在 PubMed 中搜索了 2013 年 3 月的研究，以确定评估侵袭性治疗效果的儿童和青少年复杂性区域疼痛综合征的研究。符合纳入标准的有 36 项研究。文章共报道了 173 例复杂性区域疼痛综合征的儿童和青少年。通常情况下，许多研究的方法学质量较差。应用最广泛的侵袭性治疗是单一交感神经阻滞，其次是硬膜外导管和连续交感神经阻滞。很少有脊髓刺激和疼痛导向手术的报道。个别患者经常接受不止一种侵袭性治疗。关于疗效，大约所有患者的疼痛和功能障碍都有所改善。然而，这些结果很少用有效的工具进行评估。总之，侵袭性治疗儿童和青少年复杂性区域疼痛综合征的证据水平较弱。
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