Neuropathic pain following multilevel surgery in children with cerebral palsy: a case series and review.
Six children with cerebral palsy are presented who developed neuropathic pain following multilevel orthopedic surgery. This significant complication is previously unreported. The diagnosis and treatment options are reviewed. Treatment should be kept as simple and noninvasive as possible, and aim to enable physiotherapy to continue. Early recognition and interdisciplinary treatment is important to prevent a downward spiral of increasing pain and decreased function. A good outcome in respect of improved pain and functioning was achieved in five of these six children. It is our opinion that this complication should form part of informed consent for multilevel surgery and that anesthetists should be aware of this complication when managing postoperative pain control.
Lauder
G R
GR
Bristol Royal Hospital for Children, Bristol, UK. Gillian.Lauder@ubht.swest.nhs.uk
White
M C
MC
D000293:Adolescent; D000588:Amines / Q000627:therapeutic use; D000639:Amitriptyline / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000150:complications* / Q000601:surgery; D002648:Child; D002908:Chronic Disease; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D010348:Patient Care Team; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D026741:Physical Therapy Modalities; D011613:Psychotherapy; D011782:Quadriplegia / Q000209:etiology / Q000601:surgery; D004561:Transcutaneous Electric Nerve Stimulation; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D000639:Amitriptyline; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin