Short- and Long-term Results of an Inpatient Programme to Manage Complex Regional Pain Syndrome in Children and Adolescents

Overview

Journal Br J Pain

Date 2017 May 12

PMID 28491301

Citations 3

Authors

Giovanni Cucchiaro

Kevin Craig

Kerri Marks

Kristin Cooley

Thalitha Kay Black Cox

Jennifer Schwartz

Affiliations

Soon will be listed here.

Abstract

The aim of this retrospective study was to determine whether an inpatient approach and the use of regional anaesthesia techniques can accelerate the recovery to normal functions in children with Complex Regional Pain Syndrome (CRPS). This study looked at the data of patients admitted to the rehabilitation unit with a diagnosis of CRPS from January 2010 to April 2015. Variables such as hospital stay, medications administered, regional anaesthesia procedures, changes in functional status prior to treatment and at the time of discharge, psychological evaluation and diagnosis were evaluated. A total of 31 patients (21 females and 10 males) were admitted with a diagnosis of CRPS 1 and 2. In all, 97% of the patients received a peripheral or central nerve catheter for an average of 4 days with pain scores of Verbal Numeric Scale (VNS) score = 1.0 ± 0.7 and an average length of hospital stay of 8.2 ± 2.6 days. The modified Functional Independence Measure for Children (WeeFIM) scores and Canadian Association of Occupational Therapists tests significantly improved at the time of hospital discharge, as well as their pain scores, which decreased from 8.2 ± 2 to 1.6 ± 3. In conclusion, these data suggest that the use of regional anaesthesia techniques and an intensive inpatient rehabilitation programme could accelerate the recovery of children with CRPS.

Citing Articles

Demographics, Diagnoses, Drugs, and Adjuvants in Patients on Chronic Opioid Therapy vs. Intermittent Use in a Tertiary Pediatric Chronic Pain Clinic.

Tolley J, Michel M, Sarmiento E Children (Basel). 2023; 10(1).

PMID: 36670588 PMC: 9856724. DOI: 10.3390/children10010037.

Complex Regional Pain Syndrome Caused by an Axillary Lipoma.

Patel R, Sheth R, Hus N Cureus. 2021; 12(12):e12280.

PMID: 33510987 PMC: 7828746. DOI: 10.7759/cureus.12280.

Ultrasound-guided upper and lower extremity nerve blocks in children.

Merella F, Mossetti V BJA Educ. 2021; 20(2):42-50.

PMID: 33456929 PMC: 7807837. DOI: 10.1016/j.bjae.2019.11.003.

References

Otis J, Sanderson K, Hardway C, Pincus M, Tun C, Soumekh S . A randomized controlled pilot study of a cognitive-behavioral therapy approach for painful diabetic peripheral neuropathy. J Pain. 2013; 14(5):475-82. DOI: 10.1016/j.jpain.2012.12.013. View

Ziviani J, Ottenbacher K, Shephard K, Foreman S, Astbury W, Ireland P . Concurrent validity of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries. Phys Occup Ther Pediatr. 2002; 21(2-3):91-101. View

Sherry D, Weisman R . Psychologic aspects of childhood reflex neurovascular dystrophy. Pediatrics. 1988; 81(4):572-8. View

Wesdock K, Stanton R, Singsen B . Reflex sympathetic dystrophy in children. A physical therapy approach. Arthritis Care Res. 1991; 4(1):32-8. DOI: 10.1002/art.1790040107. View

Low A, Ward K, Wines A . Pediatric complex regional pain syndrome. J Pediatr Orthop. 2007; 27(5):567-72. DOI: 10.1097/BPO.0b013e318070cc4d. View

Everett A, McLean B, Plunkett A, Buckenmaier C . A unique presentation of complex regional pain syndrome type I treated with a continuous sciatic peripheral nerve block and parenteral ketamine infusion: a case report. Pain Med. 2009; 10(6):1136-9. DOI: 10.1111/j.1526-4637.2009.00684.x. View

Watson H, Carlson L . Treatment of reflex sympathetic dystrophy of the hand with an active "stress loading" program. J Hand Surg Am. 1987; 12(5 Pt 1):779-85. DOI: 10.1016/s0363-5023(87)80069-2. View

Lee B, Scharff L, Sethna N, McCarthy C, Scott-Sutherland J, Shea A . Physical therapy and cognitive-behavioral treatment for complex regional pain syndromes. J Pediatr. 2002; 141(1):135-40. DOI: 10.1067/mpd.2002.124380. View

Borchers A, Gershwin M . Complex regional pain syndrome: a comprehensive and critical review. Autoimmun Rev. 2013; 13(3):242-65. DOI: 10.1016/j.autrev.2013.10.006. View

10.

Betend B, Lebacq E, Kohler R, David L . [Metaphyseal osteolysis. Unusual aspect of reflex algodystrophy in children (author's transl)]. Arch Fr Pediatr. 1981; 38(2):121-3. View

11.

Berde C, Lebel A . Complex regional pain syndromes in children and adolescents. Anesthesiology. 2005; 102(2):252-5. DOI: 10.1097/00000542-200502000-00003. View

12.

Zernikow B, Dobe M, Hirschfeld G, Blankenburg M, Reuther M, Maier C . [Please don't hurt me!: a plea against invasive procedures in children and adolescents with complex regional pain syndrome (CRPS)]. Schmerz. 2012; 26(4):389-95. DOI: 10.1007/s00482-012-1164-2. View

13.

Harden R, Bruehl S, Stanton-Hicks M, Wilson P . Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007; 8(4):326-31. DOI: 10.1111/j.1526-4637.2006.00169.x. View

14.

Murray C, Cohen A, Perkins T, Davidson J, Sills J . Morbidity in reflex sympathetic dystrophy. Arch Dis Child. 2000; 82(3):231-3. PMC: 1718226. DOI: 10.1136/adc.82.3.231. View

15.

Detaille V, Busnel F, Ravary H, Jacquot A, Katz D, Allano G . Use of continuous interscalene brachial plexus block and rehabilitation to treat complex regional pain syndrome of the shoulder. Ann Phys Rehabil Med. 2010; 53(6-7):406-16. DOI: 10.1016/j.rehab.2010.06.002. View

16.

Meier P, Zurakowski D, Berde C, Sethna N . Lumbar sympathetic blockade in children with complex regional pain syndromes: a double blind placebo-controlled crossover trial. Anesthesiology. 2009; 111(2):372-80. PMC: 2724014. DOI: 10.1097/ALN.0b013e3181aaea90. View

17.

BERNSTEIN B, Singsen B, Kent J, Kornreich H, King K, Hicks R . Reflex neurovascular dystrophy in childhood. J Pediatr. 1978; 93(2):211-5. DOI: 10.1016/s0022-3476(78)80498-3. View

18.

Wilder R, Berde C, Wolohan M, Vieyra M, Masek B, Micheli L . Reflex sympathetic dystrophy in children. Clinical characteristics and follow-up of seventy patients. J Bone Joint Surg Am. 1992; 74(6):910-9. View

19.

Bailey B, Daoust R, Doyon-Trottier E, Dauphin-Pierre S, Gravel J . Validation and properties of the verbal numeric scale in children with acute pain. Pain. 2010; 149(2):216-221. DOI: 10.1016/j.pain.2009.12.008. View

20.

Logan D, Williams S, Carullo V, Claar R, Bruehl S, Berde C . Children and adolescents with complex regional pain syndrome: more psychologically distressed than other children in pain?. Pain Res Manag. 2013; 18(2):87-93. PMC: 3718058. DOI: 10.1155/2013/964352. View