Broman Johanna, Weigel Cathrin, Hellmundt Ludwig, Persson Anna
Department of Clinical Sciences Lund/Helsingborg, Anesthesiology and Intensive Care Medicine Lund University Lund Sweden.
Department of Anesthesiology and Intensive Care Medicine Helsingborg Hospital Helsingborg Sweden.
Paediatr Neonatal Pain. 2021 Nov 14;3(4):163-169. doi: 10.1002/pne2.12064. eCollection 2021 Dec.
Pediatric complex regional pain syndrome (pCRPS) is a rare, painful state that often occurs as a complication following physical trauma. Diagnosis and treatment require specialist expertise in a multidisciplinary setting. Treatment is focused on pain reduction and improvement in function, which differs from the treatment of adult CRPS. We performed a cross-sectional survey with the aim of identifying pain centers in the Nordic countries and Germany that specialized in treating children with pain, especially pCRPS, and sought to describe their treatment strategies. Centers and health-care professionals working with children experiencing chronic pain were identified using internet search engines, phones, or e-mail. A standardized set of questions and an electronic questionnaire were answered by the participants. A total of 28 participants were identified in 24 centers, which were involved with patients having pCRPS (Germany: 7, Norway: 7, Sweden: 5, Finland: 5, Denmark: 3, and Island: 1). One center in Germany treated more than 20 patients per year. Half of the identified centers (n = 12) treated between 1 and 5 children with pCRPS per year. Guidelines for treating pCRPS were reportedly followed by 9/28 responders (32%), and physiotherapy was reported to be part of the treatment routine in most centers (74%). Interventional anesthesia was rarely used. Psychological therapy: 57% answered that it was always offered, 30% replied that it was proffered in most cases, and 13% responded that it was recommended in only a few patients. Pharmacological treatments were not commonly used. Treatment resources for pCRPS are scarce in the Nordic countries and Germany. Most centers treated very few children with pCRPS and did not have established guidelines. A multidisciplinary approach was used by many centers, most often combining physiotherapy and psychotherapy, and less commonly pharmacological treatment. The difficulties in diagnosing pCRPS and finding official referral units are unfortunate, considering the potentially favorable outcome with adequate treatment.
小儿复杂性区域疼痛综合征（pCRPS）是一种罕见的疼痛性疾病，常作为身体创伤后的并发症出现。诊断和治疗需要多学科背景的专业知识。其治疗重点在于减轻疼痛和改善功能，这与成人CRPS的治疗有所不同。我们进行了一项横断面调查，旨在确定北欧国家和德国专门治疗疼痛儿童（尤其是pCRPS）的疼痛中心，并试图描述其治疗策略。通过互联网搜索引擎、电话或电子邮件确定了与慢性疼痛儿童打交道的中心和医疗保健专业人员。参与者回答了一套标准化问题和一份电子问卷。在24个中心共确定了28名参与者，这些中心都收治pCRPS患者（德国：7个，挪威：7个，瑞典：5个，芬兰：5个，丹麦：3个，冰岛：1个）。德国有一个中心每年治疗超过20名患者。半数已确定的中心（n = 12）每年治疗1至5名pCRPS儿童。据报告，28名受访者中有9名（32%）遵循pCRPS治疗指南，大多数中心（74%）称物理治疗是治疗常规的一部分。很少使用介入性麻醉。心理治疗方面：57%的受访者表示总是提供心理治疗，30%回答在大多数情况下提供，13%称仅在少数患者中推荐。药物治疗并不常用。在北欧国家和德国，pCRPS的治疗资源稀缺。大多数中心治疗的pCRPS儿童极少，且没有既定的指南。许多中心采用多学科方法，最常见的是将物理治疗和心理治疗相结合，较少采用药物治疗。考虑到适当治疗可能带来良好结果，pCRPS诊断困难以及难以找到官方转诊单位的情况令人遗憾。
