title: Invasive treatments for complex regional pain syndrome in children and adolescents: a scoping review.
abstract: This review aimed to synthesize the current evidence on the effectiveness of invasive treatments for complex regional pain syndrome in children and adolescents. Studies on children and adolescents with complex regional pain syndrome that evaluated the effects of invasive treatment were identified in PubMed (search March 2013). Thirty-six studies met the inclusion criteria. Articles reported on a total of 173 children and adolescents with complex regional pain syndrome. Generally, many studies lack methodological quality. The invasive treatments applied most often were singular sympathetic blocks, followed by epidural catheters and continuous sympathetic blocks. Rarely, spinal cord stimulation and pain-directed surgeries were reported. An individual patient frequently received more than one invasive procedure. Concerning outcome, for approximately all patients, an improvement in pain and functional disability was reported. However, these outcomes were seldom assessed with validated tools. In conclusion, the evidence level for invasive therapies in the treatment of complex regional pain syndrome in children and adolescents is weak.
authors.affiliation: From the Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, School of Medicine, Witten, Germany (B.Z., J.W.); German Paediatric Pain Centre, Children's Hospital, Datteln, Germany (B.Z., J.W., H.B., G.H.); University of Applied Sciences, Osnabrück, Germany (G.H.); and Department of Pain Management, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr University Bochum, Bochum, Germany (C.M.).
authors.forename: Boris
authors.initials: B
authors.lastname: Zernikow
authors.forename: Julia
authors.initials: J
authors.lastname: Wager
authors.forename: Hannah
authors.initials: H
authors.lastname: Brehmer
authors.forename: Gerrit
authors.initials: G
authors.lastname: Hirschfeld
authors.forename: Christoph
authors.initials: C
authors.lastname: Maier
mesh_terms: D000293:Adolescent; D001340:Autonomic Nerve Block / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D059408:Pain Management / Q000379:methods*; D016896:Treatment Outcome