Prévalence et facteurs de risque de douleurs post-opératoires persistantes après chirurgie de correction thoracique et scoliotique chez l’enfant communicant et non communicant

Abstract : Objective: after major surgery, children may develop chronic postsurgical pain (CPSP) which has a neuropathic component in most cases. This study investigated CPSP after major surgery, including thoracic and scoliosis surgery, in communicating and non communicating children. Methods: this prospective, single-centre observational study was performed in children between 6 and 18 years old, scheduled for thoracic surgery for pectus excavatum correction or scoliosis surgery. We investigated the presence of pain 4 months after surgery, using a numerical rating scale (NRS) ≥ 3/10 in the communicating children or by a FLACC (Face Legs Activity Cry Consolability) ≥ 3/10 score in the non communicating children. All perioperative data regarding the surgery and anaesthesia were collected. Results: the 66 children enrolled in the study consisted of 33 communicating and 4 non communicating children undergoing scoliosis surgery, and 29 undergoing thoracic surgery. Twenty-eight (42%) of the children suffered from chronic postsurgical pain (NRS or FLACC ≥ 3/10), 4 months after surgery, with severe pain in 25% of the children. Fourteen of these children suffered from chronic neuropathic pain. Moderate to severe pain on postoperative day 3, and the cumulative number of days with pain after hospital discharge were predictors of CPSP. Conclusions: paediatric CPSP is common after major surgery, and is often associated with moderate to severe pain. Pain should be evaluated systematically for all children and the development of an interdisciplinary programme to follow-up children and parents may be helpful.
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Master Thesis
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Submitted on : Friday, March 15, 2019 - 6:46:58 PM
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Cécile Foumenteze. Prévalence et facteurs de risque de douleurs post-opératoires persistantes après chirurgie de correction thoracique et scoliotique chez l’enfant communicant et non communicant. Médecine humaine et pathologie. 2018. ⟨dumas-02069711⟩

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