Almost one in four children who undergo major surgery complain of moderate to severe pain one year after the procedure, a York University study reveals.
“Children who reported pain of an intensity of three or higher [on a scale of 0-10] two weeks after surgery faced more than double the risk of developing chronic post-surgical pain than those who reported a pain score under three,” says Gabrielle Pagé, a psychology graduate student who led the research co-authored by York Professor Joel Katz, Canada Research Chair in Health Psychology.
The researchers examined psychological factors usually associated with pain and found that the more unpleasant the post-surgical pain was after two days, the higher the chances that a child would develop moderate to severe pain six months down the road.
The nature of the pain also changes over time, says Katz. “The factors that predicted chronic pain at six months and 12 months were different. For example, children who scored higher on a measure of anxiety sensitivity after the six-month period were more likely to report moderate to severe pain at the one-year mark than those who scored lower. But anxiety sensitivity measured two weeks after surgery did not predict the occurrence of pain at six months.”
According to the study, chronic pain may be curbed from developing, through preventive treatments before and after surgery. Pharmacological, social, psychological or a combination of treatments, either before surgery or in the first few weeks following surgery, could also reduce the chance or the intensity of chronic pain after surgery.
For the longitudinal study, published in the Journal of Pain Research, 83 children (ages eight to 18) and one of their respective parents were recruited 48 to 72 hours after major general or orthopedic surgery and were followed up two weeks, six months and 12 months after surgery.
Hospital for Sick Children (SickKids) researchers Dr. Fiona Campbell, Dr. Lisa Isaac and Dr. Jennifer Stinson were co-investigators of the study supported by a Canadian Institutes of Health Research (CIHR) Frederick Banting and Charles Best Canada Graduate Scholarship — Doctoral Award granted to Pagé, also a trainee member of CIHR’s Pain in Child Health initiative.