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Chronic pain in children after cardiac surgery via sternotomy

Published online by Cambridge University Press:  18 September 2013

Mette H. Lauridsen ,
Anders D. Kristensen ,
Vibeke E. Hjortdal ,
Troels S. Jensen  and
Lone Nikolajsen
Mette H. Lauridsen
Affiliation:
Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
Anders D. Kristensen
Affiliation:
Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
Troels S. Jensen
Affiliation:
Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark
Lone Nikolajsen*
Affiliation:
Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark
*
Correspondence to: L. Nikolajsen, MD, DMSc, Danish Pain Research Center, Aarhus University Hospital, Norrebrogade 44, building 1 A, 8000 Aarhus C, Denmark. Tel: +45 78464317; Fax: +45 78463269; E-mail: lone.nikolajsen@ki.au.dk
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Abstract

Introduction

Chronic pain is common after sternotomy in adults with reported prevalence rates of 20–50%. So far, no studies have examined whether children develop chronic pain after sternotomy.

Material and methods

Postal questionnaires were sent to 171 children 10–60 months after undergoing cardiac surgery via sternotomy at the age of 0–12 years. The children were asked to recall the intensity and duration of their post-operative pain, if necessary with the help from their parents, and to describe the intensity and character of any present pain. Another group of 13 children underwent quantitative sensory testing of the scar area 3 months after sternotomy.

Results

A total of 121 children, median (range) age 7.7 (4.2–16.9) years, answered the questionnaire. Their age at the time of surgery was median (range) 3.8 (0–12.9) years, and the follow-up period was median (range) 4 (0.8–5.1) years. In all, 26 children (21%) reported present pain and/or pain within the last week located in the scar area; in 12 (46%) out of the 26 children, the intensity was ≥4 on a numeric rating scale (0–10). Quantitative sensory testing of the scar area revealed sensory abnormalities – pinprick hyperalgesia and brush and cold allodynia – in 10 out of 13 children.

Conclusion

Chronic pain after cardiac surgery via sternotomy in children is a problem that should not be neglected. The pain is likely to have a neuropathic component as suggested by the sensory abnormalities demonstrated by quantitative sensory testing.

Keywords

Congenital heart diseasechildrensternotomychronic pain
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 5 , October 2014 , pp. 893 - 899
Copyright
Copyright © Cambridge University Press 2013 

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