CHU de Bordeaux, Service d'Anesthésie Pédiatrique, Hôpital Pellegrin, Place Amélie Raba Léon, F-33076 Bordeaux, France
CHU de Bordeaux, Service d'Anesthésie Pédiatrique, Hôpital Pellegrin, Place Amélie Raba Léon, F-33076 Bordeaux, France.
Br J Anaesth. 2016 Oct;117(4):489-496. doi: 10.1093/bja/aew260. Epub 2016 Oct 17.
Chronic postsurgical pain (CPSP) is well known in adults, with prevalence rates ranging from 10 to 50%. Little is known about the epidemiology of CPSP in children. The aim of this prospective observational study was to evaluate the prevalence of CPSP after surgery in children.
After informed consent, children aged six to18 yr were included. Characteristics and risk factors for CPSP were recorded. Exclusion criteria included ambulatory surgery, refusal, inability to understand and change of address. All eligible children completed a preoperative questionnaire the day before surgery about pain, anxiety and their medical history. All data concerning anaesthetic and surgical procedures, such as acute pain scores (VAS) during the first 24 h were recorded. Three months after surgery all included children were sent a postoperative questionnaire about pain at the surgical site.
Altogether, 291 children were enrolled; the mean age was 12 yr, most subjects were male (60%). The most common type of surgery was orthopaedic (63%). In the 258 patients who completed the study, the prevalence of CPSP was 10.9%, most often with a neuropathic origin (64.3%). The two main risk factors were the existence of recent pain before surgery (<1 month) and the severity of acute postoperative pain (VAS >30 mm) in the first 24 h after orthopaedic and thoracic surgeries. Six months after surgery, only five children needed a visit with a chronic pain practitioner.
These results highlight the necessity of evaluating and treating perioperative pain in order to prevent CPSP in children.
慢性术后疼痛（CPSP）在成人中较为常见，患病率为 10%至 50%。儿童 CPSP 的流行病学情况知之甚少。本前瞻性观察研究旨在评估儿童手术后 CPSP 的发生率。
在获得知情同意后，纳入年龄为 6 至 18 岁的儿童。记录 CPSP 的特征和危险因素。排除标准包括日间手术、拒绝、无法理解和地址变更。所有符合条件的儿童均在手术前一天填写一份关于疼痛、焦虑和病史的术前问卷。记录所有与麻醉和手术程序相关的数据，如术后 24 小时内的急性疼痛评分（VAS）。术后 3 个月，所有纳入的儿童均收到一份关于手术部位疼痛的术后问卷。
共纳入 291 名儿童；平均年龄为 12 岁，大多数为男性（60%）。最常见的手术类型是骨科手术（63%）。在完成研究的 258 名患者中，CPSP 的发生率为 10.9%，最常见的类型为神经病理性疼痛（64.3%）。两个主要的危险因素是手术前近期疼痛（<1 个月）和骨科及胸科手术后 24 小时内急性术后疼痛的严重程度（VAS>30mm）。术后 6 个月，仅 5 名儿童需要接受慢性疼痛治疗师的就诊。
这些结果强调了评估和治疗围手术期疼痛以预防儿童 CPSP 的必要性。
