de Leeuw Thomas G, Boerlage Anneke A, van West Hanneke M, Renkens Jeroen J M, van Rosmalen Joost, Staals Lonneke M E, Weber Frank, Tibboel Dick, de Wildt Saskia N
Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.
Department of Neonatal and Pediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.
Front Pediatr. 2024 Jan 19;12:1293588. doi: 10.3389/fped.2024.1293588. eCollection 2024.
Approximately 50% of adolescents who have undergone scoliosis surgery still experience severe pain one year postoperatively. We explored the postoperative pain trajectory and the potential value of preoperative Thermal Quantitative Sensory Testing (T-QST) as predictor of chronic postsurgical pain after scoliosis surgery.
Single-center prospective cohort study in adolescents undergoing scoliosis surgery.
Prevalence of chronic postsurgical pain (CPSP) one year after scoliosis surgery and postsurgical pain course during this year. The need for rescue medication and the relationship between pre-operative T-QST, acute pain and CPSP.
Thirty-nine patients (mean age 13.9 years; SD 1.9 years) completed the study. One year postoperatively, ten patients (26%) self-reported pain [numeric rating scale (NRS) score ≥ 4]) when moving and two (5%) when in rest. Four of these patients (10.3%) experienced neuropathic pain. The pre-operative cold pain threshold was lower ( = 0.002) in patients with CPSP at 12 months. Preoperative cold and heat pain thresholds were correlated with the number of moderate or severe pain reports (NRS ≥ 4) in the first week postoperatively ( -.426; = 0.009 and .392; = 0.016, respectively).
One year after scoliosis surgery, a significant part of patients (26%) still reported pain, some with neuropathic characteristics. Better diagnosis and treatment is needed; our study suggests that T-QST could be further explored to better understand and treat children with this negative outcome.
接受脊柱侧弯手术的青少年中，约50%在术后一年仍经历严重疼痛。我们探讨了术后疼痛轨迹以及术前热定量感觉测试（T-QST）作为脊柱侧弯手术后慢性术后疼痛预测指标的潜在价值。
对接受脊柱侧弯手术的青少年进行单中心前瞻性队列研究。
脊柱侧弯手术后一年慢性术后疼痛（CPSP）的患病率以及这一年中的术后疼痛过程。急救药物的需求以及术前T-QST、急性疼痛和CPSP之间的关系。
39名患者（平均年龄13.9岁；标准差1.9岁）完成了研究。术后一年，10名患者（26%）在活动时自我报告疼痛[数字评分量表（NRS）评分≥4]，2名患者（5%）在休息时报告疼痛。其中4名患者（10.3%）经历神经性疼痛。12个月时患有CPSP的患者术前冷痛阈值较低（=0.002）。术前冷痛和热痛阈值与术后第一周中度或重度疼痛报告（NRS≥4）的数量相关（分别为-.426；=0.009和.392；=0.016）。
脊柱侧弯手术后一年，相当一部分患者（26%）仍报告疼痛，部分具有神经性特征。需要更好的诊断和治疗；我们的研究表明，可以进一步探索T-QST以更好地理解和治疗有这种不良结果的儿童。
