• M Gabrielle Pagé, Jennifer Stinson, Fiona Campbell, Lisa Isaac, and Joel Katz.
• Department of Psychology, York University, Toronto, ON, Canada.
• J Pain Res. 2013 Jan 1;6:167-80.

BackgroundThe goals of this study were to examine the trajectory of pediatric chronic postsurgical pain (CPSP) over the first year after surgery and to identify acute postsurgical predictors of CPSP.MethodsEighty-three children aged 8-18 years (mean 13.8, standard deviation 2.4) who underwent major orthopedic or general surgery completed pain and pain-related psychological measures at 48-72 hours, 2 weeks (pain anxiety and pain measures only), and 6 and 12 months after surgery.ResultsResults showed that 1 year after surgery, 22% of children developed moderate to severe CPSP with minimal functional disability. Children who reported a Numeric Rating Scale pain-intensity score ≥ 3 out of 10 two weeks after discharge were more than three times as likely to develop moderate/severe CPSP at 6 months and more than twice as likely to develop moderate/severe CPSP at 12 months than those who reported a Numeric Rating Scale pain score < 3 (6-month relative risk 3.3, 95% confidence interval 1.2-9.0 and 12-month relative risk 2.5, 95% confidence interval 0.9-7.5). Pain unpleasantness predicted the transition from acute to moderate/severe CPSP, whereas anxiety sensitivity predicted the maintenance of moderate/severe CPSP from 6 to 12 months after surgery.ConclusionsThis study highlights the prevalence of pediatric CPSP and the role played by psychological variables in its development/maintenance. Risk factors that are associated with the development of CPSP are different from those that maintain it.

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