[Please don't hurt me!: a plea against invasive procedures in children and adolescents with complex regional pain syndrome (CRPS)]

Schmerz. 2012 Aug;26(4):389-95. doi: 10.1007/s00482-012-1164-2.
[Article in German]

Abstract

Background: Complex regional pain syndrome (CRPS; formerly known as Morbus Sudeck/reflex dystrophy) is diagnosed in children and adolescents, but the clinical presentation is often atypical. Unfortunately, potentially harmful, invasive treatments are used in pediatric patients.

Patients and methods: A retrospective chart study of pediatric chronic pain patients with CRPS was performed.

Results: Over the course of 6 years, 37 (35 girls) children and adolescents took part in a multidisciplinary chronic pain inpatient program. At admission, patients took on average 4.4 (range 1-10) different medications and 29 different pharmaceuticals were used overall. Prior to admission, invasive pain treatments were performed without success in 16 of the children (43%). At least 13 children received two or more invasive treatments. Although sympathetic blocks were most prevalent, operations and regional anesthesia were also used.

Conclusion: Despite a lack of evidence for invasive procedures, these continue to be used in children and adolescents with CRPS, who later respond positively to conventional treatment. The English full-text version of this article is available at SpringerLink (under "Supplemental").

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Analgesics / adverse effects
  • Analgesics / therapeutic use
  • Anesthesia, Conduction / psychology
  • Autonomic Nerve Block / psychology
  • Child
  • Combined Modality Therapy
  • Complex Regional Pain Syndromes / psychology*
  • Complex Regional Pain Syndromes / therapy*
  • Cooperative Behavior
  • Disability Evaluation
  • Female
  • Hospitalization
  • Humans
  • Interdisciplinary Communication
  • Life Change Events
  • Male
  • Pain Management / methods*
  • Pain Management / psychology*
  • Pain Measurement / psychology
  • Patient Readmission
  • Retrospective Studies
  • Surgical Procedures, Operative / psychology*

Substances

  • Analgesics