Cucchiaro Giovanni, Craig Kevin, Marks Kerri, Cooley Kristin, Cox Thalitha Kay Black, Schwartz Jennifer
Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Br J Pain. 2017 May;11(2):87-96. doi: 10.1177/2049463717695695. Epub 2017 Feb 1.
The aim of this retrospective study was to determine whether an inpatient approach and the use of regional anaesthesia techniques can accelerate the recovery to normal functions in children with Complex Regional Pain Syndrome (CRPS). This study looked at the data of patients admitted to the rehabilitation unit with a diagnosis of CRPS from January 2010 to April 2015. Variables such as hospital stay, medications administered, regional anaesthesia procedures, changes in functional status prior to treatment and at the time of discharge, psychological evaluation and diagnosis were evaluated. A total of 31 patients (21 females and 10 males) were admitted with a diagnosis of CRPS 1 and 2. In all, 97% of the patients received a peripheral or central nerve catheter for an average of 4 days with pain scores of Verbal Numeric Scale (VNS) score = 1.0 ± 0.7 and an average length of hospital stay of 8.2 ± 2.6 days. The modified Functional Independence Measure for Children (WeeFIM) scores and Canadian Association of Occupational Therapists tests significantly improved at the time of hospital discharge, as well as their pain scores, which decreased from 8.2 ± 2 to 1.6 ± 3. In conclusion, these data suggest that the use of regional anaesthesia techniques and an intensive inpatient rehabilitation programme could accelerate the recovery of children with CRPS.
这项回顾性研究的目的是确定住院治疗方法和区域麻醉技术的使用是否能加速复杂性区域疼痛综合征(CRPS)患儿恢复正常功能。本研究查看了2010年1月至2015年4月间被收治入康复科且诊断为CRPS的患者数据。对住院时间、所使用药物、区域麻醉程序、治疗前及出院时功能状态的变化、心理评估及诊断等变量进行了评估。共有31例患者(21例女性和10例男性)被诊断为CRPS 1型和2型并入院。总体而言,97%的患者接受了外周或中心神经导管置入,平均时长4天,言语数字评分量表(VNS)疼痛评分为1.0±0.7,平均住院时长为8.2±2.6天。改良儿童功能独立性评定量表(WeeFIM)评分及加拿大职业治疗师协会测试在出院时均有显著改善,疼痛评分也从8.2±2降至1.6±3。总之,这些数据表明,区域麻醉技术的使用和强化住院康复计划可加速CRPS患儿的康复。