DOS Kongressen 2014 ·
181
Are pain thresholds in children influenced by
orthopedic surgery? - A prospective study
Line Kjeldgaard Pedersen, Polina Martinkevich, Ole Rahbek, Lone Nikolajsen,
Bjarne Møller-Madsen
Department of Childrens Orthopedics,
, Aarhus University
Hospital; Department of Anaestesiology, Aarhus University Hospital
Background:
The threshold for pain can be measured quantitatively by pressure
algometry. To our knowledge pain thresholds in children undergoing orthopedic
surgery have never been investigated.
Purpose / Aim of Study:
To assess pressure pain thresholds (PPT) and level of
pain in children before and after orthopedic surgery.
Materials and Methods:
24 children aged 6-16 years were included. PPT and
Numerical Rating Scale (NRS) were obtained at 3-6 weeks before surgery, on
the day of surgery, the first day and 6-12 weeks after surgery. A Somedic®
pressure algometer was used on the thenar of the dominant hand and the lat-
eral part of the lower leg. PPT is defined as the minimum pressure applied that
induces pain.
Findings / Results:
A decrease in PPT between 3-6 weeks before surgery
and the first postoperative day of 20,16 kPa (p=0,20) and 47,6 kPa (p=0,04)
was measured by pressure algometry on both the hand and the leg, respec-
tively. An increase in PPT between the first postoperative day and follow-up at
6-12 weeks of 35,7 kPa (p<0,01) and 119,3 kPa (p<0,01) was observed. NRS
showed significant changes between these periods (p=0,04; p<0,01; p<0,01).
No significant correlations between PPT for both hand and leg measurements
and NRS were found. Age and sex of the child influenced pain perception.
Conclusions:
Children undergoing orthopedic surgery demonstrate significant
changes in PPT. The pressure pain threshold decreases in the period between
3-6 weeks preoperatively and increases to a usual level at 6-12 weeks postop-
eratively, though no correlation between the PPT and NRS could be document-
ed. It is unknown how PPT is influenced by surgery. Modulation of pain threshold
could improve future pain management and reduce consumptions of opioids.
128.
