Department of Orthopaedic Surgery, Hvidovre University Hospital, Hvidovre, Denmark.
Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.
Scand J Pain. 2023 Jun 2;23(3):546-552. doi: 10.1515/sjpain-2022-0124. Print 2023 Jul 26.
To investigate if chronic pain in children with cerebral palsy is undertreated with the current pharmacological/non-pharmacological interventions using a pain management index.
Parents of 120 children with cerebral palsy between the ages of 2-19 years from our region in Denmark answered a questionnaire about whether their child had everyday pain. When answering in pain, we inquired about pain status and pharmacological/non-pharmacological pain coping interventions. Everyday pain was viewed as chronic pain with acute exacerbations. Pain experienced was divided into worst pain (highest moments of pain intensity) and least pain (lowest moments of pain intensity). To describe and evaluate the effectiveness of pain interventions used, a pain management index was utilized. Everyday pain was assessed using a logistical regression by adjusting for age, sex, and gross motor function classification system level.
59/115 (0.51) of parents answering the questionnaire reported everyday pain. Of those, the median age was 10 years. For pain alleviation, massage was reported by parents as being used by 29/59 (0.49) children and paracetamol by 21/59 (0.36). Pain affected daily life in 44/59 (0.75). By our evaluation 44/59 (0.75) were inadequately treated for their pain. Our evaluation also revealed that 19/59 (0.32) of children in pain had inadequately treated pain combined with an undesirable intensity of least pain.
Half of the children with cerebral palsy experienced chronic pain according to our pain questionnaire answered by parents. Among these children three-quarters were insufficiently treated for their pain. In the same group, one-third were impacted by pain felt at both its highest and lowest moments of intensity. Massage therapy and paracetamol were the most frequently utilized pain-alleviating interventions. In our cohort, pain was undertreated and likely underdiagnose (Protocol number H-17008823).
使用疼痛管理指数调查本地区丹麦患有脑瘫的儿童的慢性疼痛是否存在治疗不足的情况，这些儿童接受了当前的药物/非药物干预措施。
本地区 120 名年龄在 2-19 岁之间的脑瘫患儿的父母回答了一份问卷，询问他们的孩子是否每天都有疼痛。当孩子回答有疼痛时，我们会询问疼痛状况以及药物/非药物缓解疼痛的干预措施。每天都有的疼痛被视为伴有急性加重的慢性疼痛。所经历的疼痛分为最痛（疼痛强度最高的时刻）和最轻（疼痛强度最低的时刻）。为了描述和评估所使用的疼痛干预措施的效果，我们使用了疼痛管理指数。通过调整年龄、性别和粗大运动功能分类系统水平，使用逻辑回归来评估日常疼痛。
回答问卷的 115 名父母中有 59 名（0.51）报告每天都有疼痛。其中，中位数年龄为 10 岁。为了缓解疼痛，有 29/59（0.49）名儿童的父母报告使用了按摩，有 21/59（0.36）名儿童的父母报告使用了扑热息痛。44/59（0.75）名疼痛患儿的日常生活受到影响。根据我们的评估，44/59（0.75）名患儿的疼痛治疗不足。我们的评估还表明，19/59（0.32）名疼痛患儿的疼痛治疗不足，同时疼痛的最低强度也不理想。
根据我们的疼痛问卷，有一半的脑瘫患儿经历了慢性疼痛，这些患儿中有四分之三的疼痛治疗不足。在同一组中，三分之一的患儿的疼痛在最高和最低强度时都受到影响。按摩疗法和扑热息痛是最常使用的缓解疼痛的干预措施。在我们的队列中，疼痛治疗不足，且可能存在诊断不足的情况（方案编号 H-17008823）。
