[Please don't hurt me!: a plea against invasive procedures in children and adolescents with complex regional pain syndrome (CRPS)].
BACKGROUND
Complex regional pain syndrome (CRPS; formerly known as Morbus Sudeck/reflex dystrophy) is diagnosed in children and adolescents, but the clinical presentation is often atypical. Unfortunately, potentially harmful, invasive treatments are used in pediatric patients.


METHODS
A retrospective chart study of pediatric chronic pain patients with CRPS was performed.


RESULTS
Over the course of 6 years, 37 (35 girls) children and adolescents took part in a multidisciplinary chronic pain inpatient program. At admission, patients took on average 4.4 (range 1-10) different medications and 29 different pharmaceuticals were used overall. Prior to admission, invasive pain treatments were performed without success in 16 of the children (43%). At least 13 children received two or more invasive treatments. Although sympathetic blocks were most prevalent, operations and regional anesthesia were also used.


CONCLUSIONS
Despite a lack of evidence for invasive procedures, these continue to be used in children and adolescents with CRPS, who later respond positively to conventional treatment. The English full-text version of this article is available at SpringerLink (under "Supplemental").
Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland. b.zernikow@deutsches-kinderschmerzzentrum.de
B
B
Zernikow
M
M
Dobe
G
G
Hirschfeld
M
M
Blankenburg
M
M
Reuther
C
C
Maier
D000223:Adaptation, Psychological; D000293:Adolescent; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000765:Anesthesia, Conduction / Q000523:psychology; D001340:Autonomic Nerve Block / Q000523:psychology; D002648:Child; D003131:Combined Modality Therapy; D020918:Complex Regional Pain Syndromes / Q000523:psychology* / Q000628:therapy*; D003299:Cooperative Behavior; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization; D006801:Humans; D033183:Interdisciplinary Communication; D008016:Life Change Events; D008297:Male; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology; D010359:Patient Readmission; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000523:psychology*
D000700:Analgesics