幼儿慢性术后疼痛：患病率，疼痛轨迹和生理和心理预后因素

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-06-23 DOI:10.1016/j.jpain.2025.105476

Guillermo Ceniza-Bordallo , Andrés Gómez Fraile , Ibai López-de-Uralde-Villanueva , Jennifer A. Rabbitts , Rui Li , Tonya M. Palermo , Patricia Martín-Casas

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引用次数: 0

摘要

慢性术后疼痛（CPSP）的患病率和预后因素在大龄儿童和青少年已经确定。然而，年幼儿童的患病率和预后因素（可能不同于年长儿童）的研究很少。此外，存在显著的知识差距，很少有前瞻性研究调查儿科人群CPSP的长期结果。为了解决这个问题，我们的研究调查了4至7岁儿童的CPSP患病率、预后因素和疼痛轨迹，旨在提高对术后24个月内CPSP的认识。该研究注册编号为NCT04735211，包括从西班牙一所大学医院招募的113名年轻参与者（平均年龄=5.3岁，35.4%为女孩）及其父母。于术后3、6、12和24个月检查CPSP患病率。多逻辑回归模型评估手术前预测因素（儿童性别、儿童年龄、儿童疼痛强度、身体健康、心理健康、父母疼痛灾难化、疼痛恐惧）。采用基于组的轨迹模型（GBTM）分析术后疼痛轨迹。结果显示，3个月时CPSP患病率为35%，24个月时降至12%。年龄越大（aOR=1.83, 95% CI 1.11-3.03）和父母疼痛灾难化程度越高（aOR=1.20, 95% CI 1.10-1.31）与3个月时CPSP相关。GBTM确定了三种术后疼痛轨迹：低痛（27.4%）、快速恢复（53.1%）和缓慢恢复（19.5%）。研究结果为这一脆弱的年轻群体提供了新的数据，以帮助了解CPSP的患病率、生理和心理预后因素以及疼痛轨迹，从而可能导致建立预防措施。该研究为CPSP的高患病率提供了有价值的见解，CPSP的患病率在3个月时为35%，在24个月时下降到12%。它在最低限度的研究人群中确定了可改变的（例如，父母疼痛的灾难化、疼痛强度、身体健康）和不可改变的（例如，年龄）风险因素。

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Chronic postsurgical pain in young children: Prevalence, pain trajectories and physical and psychological prognostic factors

Prevalence of chronic postsurgical pain (CPSP) and prognostic factors in older children and adolescents have been identified. However, prevalence and prognostic factors in younger children, which may differ from older children, have been minimally studied. Additionally, a significant knowledge gap exists, with few prospective studies investigating long-term outcomes of CPSP in pediatric populations. To address this, our study investigates CPSP prevalence, prognostic factors, and pain trajectories in 4 to 7-year-olds, aiming to enhance understanding within the 24-month period after surgery. Registered under NCT04735211, the study includes 113 young participants (mean age=5.3 years, 35.4% girls) and their parents recruited from a university hospital in Spain. CPSP prevalence was examined at 3, 6, 12, and 24 months post-surgery. Multiple logistic regression models assessed presurgical predictors (child sex, child age, child’s pain intensity, physical health, psychological health, parent pain catastrophizing, fear of pain). Group-based trajectory modeling (GBTM) was used to analyze postsurgical pain trajectories. Results indicate a 35% CPSP prevalence at 3 months, decreasing to 12% at 24 months. Older age (aOR=1.83, 95% CI 1.11–3.03) and higher parent pain catastrophizing (aOR=1.20, 95% CI 1.10–1.31) were associated with CPSP at 3 months. GBTM identified three postsurgical pain trajectories: Low Pain (27.4%), Quick Recovery (53.1%), and Slow Recovery (19.5%). Findings provide novel data in this vulnerable younger age group to help understand prevalence of CPSP, physical and psychological prognostic factors and pain trajectories, which may lead to establishing preventative initiatives.

Perspective

This study provides valuable insights into the high prevalence of CPSP, with rates of 35% at 3 months decreasing to 12% at 24 months. It identifies both modifiable (e.g., parent pain catastrophizing, pain intensity, physical health) and non-modifiable (e.g., age) risk factors in a minimally studied population.

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.