Understanding Chronic Post-Surgical Pain in Children: A Multidimensional Approach

Sep 19, 2024

Dr. Fiona Campbell, an anesthesiologist and pain specialist from The Hospital for Sick Children in Toronto, sheds light on chronic post-surgical pain in pediatric patients. She discusses the alarming rise in prevalence and the psychological factors like anxiety that can complicate recovery. Dr. Campbell emphasizes the importance of validating children's pain and using metaphors to explain it. Additionally, she advocates for early interventions and a multidisciplinary approach to enhance treatment outcomes, addressing disparities in healthcare access.

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INSIGHT

Increasing Post-Surgical Pain Prevalence

Chronic post-surgical pain in children varies widely, with prevalence increasing over time after surgery.
Major surgeries can result in up to 50% prevalence of chronic pain even years later.

INSIGHT

Multifactorial Risk Factors

Various premorbid, biological, and psychosocial factors contribute to chronic post-surgical pain.
Psychological vulnerabilities, genetics, and social determinants of health play key roles.

INSIGHT

Healthcare Inequities in Pain

Social determinants and racial disparities affect pain assessment and treatment in children.
Minoritized groups receive less pain assessment, treatment, and referrals to specialists.

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Understanding Chronic Post-Surgical Pain in Children: A Multidimensional Approach

Chronic pain after surgery is a significant issue that can profoundly impact the lives of children and their families. In this insightful episode of the "What a Pain" podcast, Dr. Fiona Campbell, an anesthesiologist and pain specialist from The Hospital for Sick Children in Toronto, shares her expertise on persistent post-surgical pain in pediatric patients.

Through engaging discussions, Dr. Campbell explores the prevalence and risk factors associated with chronic post-surgical pain, shedding light on the often-overlooked psychological aspects of this condition. She emphasizes the importance of recognizing chronic pain as a distinct diagnosis, reducing stigma, and promoting a holistic approach to pain management.

Key topics covered in this episode include:

The alarming prevalence of chronic post-surgical pain in children and the intriguing increase in prevalence over time after surgery.
Psychological risk factors, such as pre-existing anxiety and parental catastrophising, that can contribute to the development of persistent pain.
The role of validation, reframing negative pain experiences, and fostering resilience in mitigating chronic pain.
Strategies for prevention and early intervention, including preoperative psychological screening and multidisciplinary collaboration.
The use of analogies and metaphors to help children and families understand the complexities of chronic pain.
The future of post-surgical pain: will we ever be without it?

Whether you are a healthcare professional, a patient, or a family member navigating the challenges of chronic post-surgical pain, this podcast offers invaluable insights and practical strategies. Join Dr. Campbell as she delves into the multidimensional nature of this condition.

Articles mentioned by Professor Campbell:

Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Kosek E, Lavand'homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, Wang SJ. A classification of chronic pain for ICD-11. Pain. 2015 Jun;156(6):1003-1007.
Coakley R, Schechter N. Chronic pain is like… The clinical use of analogy and metaphor in the treatment of chronic pain in children. Pediatric Pain Letter 2013;15(1):1-8. www.childpain.org/ppl

Article discussed by Konrad:

Kitschen A, Wahidie D, Meyer D, Rau LM, Ruhe AK, Wager J, Zernikow B, Sauerland D. Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents With Chronic Pain: A Systematic Review. Clin J Pain. 2024 May 1;40(5):306-319.

Authors:

Dr Glyn Williams is a Consultant paediatric anaesthetist and lead for the pain management service at Great Ormond Street Hospital, London.

Dr Konrad Jacobs is a Consultant clinical psychologist and rehabilitation lead for the Oxford Centre for Children and Young People in Pain. Twitter: @konradjacobs

Contact

Please email Glyn and Konrad with comments and feedback: whatapainpodcast@gmail.com

Follow Konrad on twitter: @konradjacobs

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