Abstract
Purpose
Chronic post-surgical pain (CPSP) is a significant concern and contributes to the
opioid epidemic; however, little is known about CPSP in young people.
Design
This prospective study aimed to identify sensory, psychological, and demographic factors
that may increase the risk of CPSP after spinal fusion surgery for children and adolescents
with idiopathic scoliosis.
Methods
32 children and adolescents from two children's hospitals completed quantitative sensory
testing (QST) and the Pain Catastrophizing Scale Child (PCS-C) pre-and 4-6 months
post spinal fusion surgery. Between-group differences were assessed using an independent
samples t-test. Pearson's correlations and stepwise linear regression were used to assess the
relationship between variables at both time points.
Results
56% of patients endorsed pain post-surgery. They were more sensitive tomechanical
detection on both a control non-pain site (r = -2.87, p = .004) and the back (r = -1.83, p = .04), as well as pressure pain (r=−2.37, p = .01) on the back. This group also reported worse pain scores pre-surgery. Pre-surgery
helplessness positively correlated with preoperative pain (r = .67 p < .001), and age was negatively correlated with the post-surgical catastrophizing
total score (r =-.39, p = .05), suggesting that younger patients endorsed more pain-related
worry after surgery.
Conclusions
Patients who present with pain during their preoperative appointment may need to be
monitored with increased vigilance throughout the perioperative period, possibly with
bedside QST and psychological questionnaires, which nurses could administer. Biobehavioral
interventions targeting pain intensity and feelings of helplessness and anxiety during
the preoperative period may alleviate the transition to CPSP.
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Article info
Publication history
Published online: December 21, 2022
Accepted:
November 13,
2022
Received in revised form:
November 11,
2022
Received:
July 1,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
