• Paediatric anaesthesia · Nov 2018

    Interventional procedures in children and adolescents with chronic non-cancer pain as part of a multidisciplinary pain treatment program.

    • Eduardo Vega, Gonzalo Rivera, Ghislaine C Echevarria, Zakhar Prylutskyy, Jordi Perez, and Pablo Ingelmo.
    • Chronic Pain Service, Department of Anesthesia, McGill University Health Center, Montreal Children's Hospital, Montreal, Québec, Canada.
    • Paediatr Anaesth. 2018 Nov 1; 28 (11): 999-1006.

    BackgroundInterventional procedures are part of multidisciplinary pain treatment programs to treat chronic non-cancer pain conditions in children and adolescents. However, the real benefit of these interventions remains unclear.AimsThe aim of this study was to analyze the potential benefits of the interventional procedures in children and adolescents with chronic non-cancer pain in the setting of a multidisciplinary pain treatment program.MethodsWe retrospectively reviewed the charts of 98 children and adolescents receiving 314 diagnostic or therapeutic interventional procedures. We applied the following definitions of efficacy Short-term positive therapeutic effect: block that produced a minimum of 50% reduction in pain intensity for at least 4 weeks. Long-term positive therapeutic effect: a patient with a minimum of 50% reduction in pain intensity for at least 6 months Full recovery: a patient free of pain, not taking analgesics with normal physical and role functioning 6 months after the last procedure.ResultsSeventy-six of 112 diagnostic blocks (68%) were associated with a 50% reduction in pain intensity for at least 4 weeks after the procedure. One hundred and sixty-six of 202 therapeutics blocks (82%) were associated with a short-term benefit. Seventy-two of 98 patients (73%) referred a 50% reduction in their pain intensity (17%) or had full recovery 6 months after the procedures (56%) and a MPTP. Psychiatric comorbidity and more advanced age were factors associated with failure to respond to interventional procedures.ConclusionThe use of interventional procedures may represent a valid therapeutic option, associated with positive clinical outcomes within a multidisciplinary program.© 2018 John Wiley & Sons Ltd.

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