A clinical profile of a cohort of patients referred to an anesthesiology-based pediatric chronic pain medicine program.


BACKGROUND:Pediatric chronic pain is very common and results in significant health care costs. Pediatric chronic pain is both an individual and a public health concern. The primary objective of this study was to generate a descriptive clinical profile of the patients referred to an anesthesiology-based pediatric chronic pain medicine program. This patient profile was intended to serve as a surrogate for a more formal population needs assessment. METHODS:A quantitative observational study design was applied. The independent study variables included the primary pain-related diagnosis, duration of pain symptoms, patient age, patient sex, insurance status, an intact biological family unit, fulltime school attendance, home schooling, and comorbid depression and/or anxiety. Using a series of previously well-validated measurement instruments, the dependent study variables included self-reported chronic pain intensity, self-reported and parent proxy-reported health-related quality of life, adverse family impact, and parental satisfaction. Study data collection occurred at the time of the first visit to the pediatric chronic pain medicine clinic but before interacting with any health care provider. RESULTS:The enrolled patients (n = 100) were predominantly adolescent females, whose chronic pain had persisted for >1 yr and whose pain was frequently accompanied by clinically significant anxiety and depression. As compared with national and state norms, a significantly disproportionate percentage had a nonintact biological family unit (P < 0.001), was not attending school fulltime (P < 0.001), and was intentionally being home-schooled (P < 0.001). Ninety-five percent of the present cohort of patients had previously been under the care of at least one other subspecialist for their chronic pain condition. The mean initial patient self-reported and initial parent proxy-reported health-related quality of life scores (PedsQL Total Score) were also significantly lower than the PedsQL Total Score values previously observed in pediatric rheumatology patients (P < 0.0001), pediatric migraine patients (P < 0.0001), and pediatric cancer patients (P < 0.0001). CONCLUSIONS:Pediatric chronic pain patients previously under the care of another subspecialist and subsequently referred to an anesthesiology-based pediatric chronic pain medicine program seemed to be experiencing significantly worse health-related quality of life. The routine assessment of chronic pain-related pediatric health-related quality of life seems feasible and worthwhile. Attention also needs to be focused on consistently addressing the strength of a patient's coping mechanisms, the presence of pain-promoting versus pain-reducing parental behaviors, and preexisting parental pain and disability.


Anesth Analg


Anesthesia and analgesia


Vetter TR




Has Abstract


2008-03-01 00:00:00


786-94, table of contents












  • Continuous femoral nerve analgesia after unilateral total knee arthroplasty: stimulating versus nonstimulating catheters.

    abstract:BACKGROUND:Continuous femoral analgesia provides extended pain relief and improved functional recovery for total knee arthroplasty (TKA). Stimulating catheters may allow more accurate placement of catheters. METHODS:We performed a randomized prospective study to investigate the use of stimulating catheters versus nons...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Hayek SM,Ritchey RM,Sessler D,Helfand R,Samuel S,Xu M,Beven M,Bourdakos D,Barsoum W,Brooks P

    更新日期:2006-12-01 00:00:00

  • Beta-adrenergic receptor function is acutely altered in surgical patients.

    abstract::Catecholamine-induced desensitization of beta-adrenergic receptors resulting in hyporesponsiveness to further stimulation has been frequently reported after an increase in endogenous catecholamines. To examine the possibility of beta-adrenoceptor desensitization due to intraoperative adrenergic activation (surgical st...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Marty J,Nimier M,Rocchiccioli C,Mantz J,Luscombe F,Henzel D,Loiseau A,Desmonts JM

    更新日期:1990-07-01 00:00:00

  • The use of fentanyl added to morphine-lidocaine-epinephrine spinal solution in patients undergoing cesarean section.

    abstract::Because of its slow onset of action, intrathecal morphine may not be the optimal drug for intraoperative analgesia during short cases, such as cesarean sections. It is not known whether adding fentanyl to a morphine-lidocaine spinal solution would provide any benefits to patients undergoing cesarean sections. Sixty-tw...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Connelly NR,Dunn SM,Ingold V,Villa EA

    更新日期:1994-05-01 00:00:00

  • A qualitative systematic review of the role of N-methyl-D-aspartate receptor antagonists in preventive analgesia.

    abstract:UNLABELLED:We evaluated in a qualitative systematic review the effect of N-methyl-D-aspartate (NMDA) receptor antagonists on reducing postoperative pain and analgesic consumption beyond the clinical duration of action of the target drug (preventive analgesia). Randomized trials examining the use of an NMDA antagonist i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: McCartney CJ,Sinha A,Katz J

    更新日期:2004-05-01 00:00:00

  • The efficacy of a novel approach to transversus abdominis plane block for postoperative analgesia after colorectal surgery.

    abstract:BACKGROUND:The analgesic efficacy of transversus abdominis plane (TAP) block has been established for patients undergoing abdominal surgery. We evaluated the efficacy of a novel approach to TAP block for postoperative analgesia after colorectal surgery. METHODS:Forty adult ASA physical status I to III patients undergo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Bharti N,Kumar P,Bala I,Gupta V

    更新日期:2011-06-01 00:00:00

  • Beta-adrenergic blockers and vasovagal episodes during shoulder surgery in the sitting position under interscalene block.

    abstract:UNLABELLED:Shoulder surgery is often performed with patients in the sitting position under interscalene block anesthesia. Vasovagal episodes, characterized by a sudden decrease in heart rate and/or blood pressure, have a reported incidence of 17%-24% in this setting. We performed a retrospective study to determine whet...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Kahn RL,Hargett MJ

    更新日期:1999-02-01 00:00:00

  • Assessment of Tricuspid Annular Motion by Speckle Tracking in Anesthetized Patients Using Transesophageal Echocardiography.

    abstract:BACKGROUND:The perioperative assessment of right ventricular (RV) function remains a challenge. Tricuspid annular plane systolic excursion (TAPSE) using M-mode is a widely used measure of RV function. However, accurate alignment of the ultrasound beam with the direction of annular movement can be difficult with transes...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Shen T,Picard MH,Hua L,Burns SM,Andrawes MN

    更新日期:2018-01-01 00:00:00

  • Potentiation and antagonism of vecuronium by decamethonium.

    abstract::Enhancement of a vecuronium neuromuscular blockade by prior administration of succinylcholine has been attributed to both pharmacokinetic and pharmacodynamic mechanisms. This study was performed to elucidate the mechanism of this interaction using decamethonium as the agonist drug. In five healthy patients undergoing ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Feldman S,Fauvel N

    更新日期:1993-03-01 00:00:00

  • Special article: airway management in reconstructive surgery for noma (cancrum oris).

    abstract::Noma (cancrum oris) is a disease of poverty and malnutrition, which predominantly affects children younger than 10 years in developing countries. Although the majority of sufferers die of sepsis at the time of the initial infection, or of subsequent starvation due to severe trismus and an inability to eat, a small min...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Coupe MH,Johnson D,Seigne P,Hamlin B

    更新日期:2013-07-01 00:00:00

  • Quantitative analysis of pulmonary clearance of exogenous dopamine after cardiopulmonary bypass in humans.

    abstract::The contribution of the lung to the clearance of exogenous dopamine after cardiopulmonary bypass (CPB) was analyzed quantitatively in humans and compared with the contribution of the lung before CPB. The pulmonary and arterial plasma concentration of dopamine and the pulmonary plasma flow were measured simultaneously ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Hayashi Y,Sumikawa K,Yamatodani A,Kamibayashi T,Mammoto T,Kuro M

    更新日期:1993-01-01 00:00:00

  • American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway.

    abstract::Patient-reported outcomes (PROs) are measures of health status that come directly from the patient. PROs are an underutilized tool in the perioperative setting. Enhanced recovery pathways (ERPs) have primarily focused on traditional measures of health care quality such as complications and hospital length of stay. The...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Abola RE,Bennett-Guerrero E,Kent ML,Feldman LS,Fiore JF Jr,Shaw AD,Thacker JKM,Gan TJ,Miller TE,Hedrick TL,McEvoy MD,Mythen MG,Bergamaschi R,Gupta R,Holubar SD,Senagore AJ,Wischmeyer PE,Carli F,Evans DC,Guilbert S,

    更新日期:2018-06-01 00:00:00

  • Argon pneumoperitoneum is more dangerous than CO2 pneumoperitoneum during venous gas embolism.

    abstract:UNLABELLED:We investigated the possibility of using argon, an inert gas, as a replacement for carbon dioxide (CO2). The tolerance of argon pneumoperitoneum was compared with that of CO2 pneumoperitoneum. Twenty pigs were anesthetized with enflurane 1.5%. Argon (n = 11) or CO2 (n = 9) pneumoperitoneum was created at 15 ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Mann C,Boccara G,Grevy V,Navarro F,Fabre JM,Colson P

    更新日期:1997-12-01 00:00:00

  • Anesthetic and hemodynamic effects of single bolus versus incremental titration of hyperbaric spinal lidocaine through microcatheter.

    abstract::This study examined anesthetic development and hemodynamic changes during two techniques of hyperbaric lidocaine administration through 27-gauge intrathecal catheters for continuous spinal anesthesia in 55 elderly patients undergoing transurethral prostatic resection. Twenty-five patients were randomly assigned to rec...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Chan VW,Chung F,Gomez M,Seyone C,Baylon G

    更新日期:1994-07-01 00:00:00

  • The Effectiveness of Applying Soft Tissue Bonding Adhesive Composed of 2-Ethyl Cyanoacrylate to Epidural Catheter Fixations Using Film Dressings: An Open-Label, Randomized, Parallel-Group Comparative Study.

    abstract:BACKGROUND:Insufficient fixation of an epidural catheter may result in migration of the catheter and eventual catheter failure. However, the best fixation method remains to be established. Aron Alpha A (2-ethyl cyanoacrylate) adhesive is approved for clinical use and can be used for surgical adhesion to both skin and b...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Tadokoro T,Kakinohana M,Navarro M,Goya M,Odo Y

    更新日期:2019-07-01 00:00:00

  • Functional residual capacity changes after different endotracheal suctioning methods.

    abstract:BACKGROUND:Our primary objective was to investigate the effects of three different endotracheal suctioning procedures on functional residual capacity (FRC). METHODS:Using a crossover design, postoperative cardiac surgery patients (n = 20) received three different suctioning methods in randomized order: closed suctioni...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Heinze H,Sedemund-Adib B,Heringlake M,Gosch UW,Eichler W

    更新日期:2008-09-01 00:00:00

  • Influence and relative sensitivities of 50-Hz and 100-Hz tetanic stimuli on subsequent tetanic fade ratios in patients receiving vecuronium.

    abstract::We studied the possible effects of repetitive (1-min interval) 50- and 100-Hz tetanic stimuli on 50-Hz and 100-Hz tetanic fade ratios (RF50HZ and RF100HZ). We also evaluated the sensitivity of the recorded responses to these two tests to assess residual neuromuscular block (isometric adductor pollicis mechanical activ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Baurain MJ,Hoton F,Dernovoi BS,d'Hollander AA

    更新日期:1996-01-01 00:00:00

  • Atracurium, vecuronium, and intraocular pressure in humans.

    abstract::We studied 60 nonophthalmologic patients, allocated to six treatment groups, to assess the effects of atracurium and vecuronium on intraocular pressure (IOP). All patients had IOP measured while awake, using pneumotonometry. In group 1, anesthesia was induced with thiopental, 5 mg/kg, and maintained with N2O, 70% in O...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Schneider MJ,Stirt JA,Finholt DA

    更新日期:1986-08-01 00:00:00

  • Esophageal insufflation with normal fiberoptic positioning of the ProSeal laryngeal mask airway.

    abstract:IMPLICATIONS:Esophageal insufflation can occur simultaneously with venting from the drain tube during positive pressure ventilation with the ProSeal laryngeal mask airway. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Stix MS,Borromeo CJ,O'Connor CJ Jr

    更新日期:2002-04-01 00:00:00

  • Anesthesia as therapy for persistent hiccups.

    abstract:IMPLICATIONS:Chronic hiccups may be a serious therapeutic problem. Pharmacological treatment with increasing dosages of baclofen, carbamazepine, or gabapentin is not always successful. In this paper, the use of general anesthesia with positive-pressure ventilation and muscle relaxation for the termination of chronic hi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Lierz P,Felleiter P

    更新日期:2002-08-01 00:00:00

  • Pharmacokinetics and pharmacodynamics of edrophonium in elderly surgical patients.

    abstract::The effect of age (over 70 yr) on the pharmacokinetics and pharmacodynamics of edrophonium was evaluated in seven patients aged 76-87 yr and in seven patients aged 27-57 yr. When elderly patients were compared with younger controls, the elderly exhibited a statistically significant decreased plasma clearance (5.9 +/- ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Matteo RS,Young WL,Ornstein E,Schwartz AE,Silverberg PA,Diaz J

    更新日期:1990-10-01 00:00:00

  • In vitro anesthetic washin and washout via bubble oxygenators: influence of anesthetic solubility and rates of carrier gas inflow and pump blood flow.

    abstract::The uptake and elimination of volatile anesthetic agents administered to patients under conditions of hemodilution and hypothermia during cardiopulmonary bypass have not been determined. To define the limitations imposed by oxygenators, we defined washin and washout curves for volatile anesthetic agents administered t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Nussmeier NA,Moskowitz GJ,Weiskopf RB,Cohen NH,Fisher DM,Eger EI 2nd

    更新日期:1988-10-01 00:00:00

  • Resveratrol regulates N-methyl-D-aspartate receptor expression and suppresses neuroinflammation in morphine-tolerant rats.

    abstract:BACKGROUND:In the present study, we examined the effects and mechanisms of the Chinese herb resveratrol on attenuation of morphine tolerance in rats. METHODS:Male Wistar rats were implanted with 2 intrathecal catheters; one catheter was connected to a mini-osmotic pump, used for either morphine (15 μg/h) or saline (1 ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tsai RY,Chou KY,Shen CH,Chien CC,Tsai WY,Huang YN,Tao PL,Lin YS,Wong CS

    更新日期:2012-10-01 00:00:00

  • Pulse oximetry for perioperative monitoring: systematic review of randomized, controlled trials.

    abstract::Monitoring with pulse oximetry might improve patient outcome by enabling an early diagnosis and, consequently, correction of perioperative events that might otherwise cause postoperative complications or even death. The aim of the study was to clarify the effect of perioperative monitoring with pulse oximetry and to i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析


    authors: Pedersen T,Møller AM,Pedersen BD

    更新日期:2003-02-01 00:00:00

  • Urine flow is a novel hemodynamic monitoring tool for the detection of hypovolemia.

    abstract:BACKGROUND:Noticeable changes in vital signs indicating hypovolemia occur only after 15% of the blood volume is lost. More sensitive variables (e.g., cardiac output, systolic pressure variation and its Δdown component) are invasive and difficult to obtain in the early phase of bleeding. Lately, a new technology for con...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Shamir MY,Kaplan L,Marans RS,Willner D,Klein Y

    更新日期:2011-03-01 00:00:00

  • Dietary omega-3 fatty acids may be associated with increased neuropathic pain in nerve-injured rats.

    abstract:UNLABELLED:Certain dietary proteins and oils are capable of decreasing chronic neuropathic pain levels in rats after partial sciatic nerve ligation injury. We tested, for the first time, the role of dietary polyunsaturated fatty acids in suppressing pain in partial sciatic nerve ligation-injured rats. Six groups of mal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Pérez J,Ware MA,Chevalier S,Gougeon R,Shir Y

    更新日期:2005-08-01 00:00:00

  • A characterization of motion affecting pulse oximetry in 350 patients.

    abstract::As part of an oximetry research effort in which plethysmographic data were collected from moving patients, a wide variety of patient motion affecting pulse oximetry was observed and characterized by the clinical incidence, type, severity and duration of patient motion. 350 patients were observed for movement in clinic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tobin RM,Pologe JA,Batchelder PB

    更新日期:2002-01-01 00:00:00

  • The Mechanism of Mitral Regurgitation Influences the Temporal Dynamics of the Vena Contracta Area as Measured with Color Flow Doppler.

    abstract:BACKGROUND:In patients with mitral regurgitation (MR), the effective regurgitant orifice area can be estimated by measuring the vena contracta area (VCA). We hypothesize that the VCA has characteristic temporal dynamics related to the underlying mechanism of functional mitral regurgitation (FMR) versus degenerative mit...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Cobey FC,Ashihkmina E,Edrich T,Fox J,Shook D,Bollen B,Breeze JL,Ursprung WW,Shernan SK

    更新日期:2016-02-01 00:00:00

  • Estimation of the length of the nares-vocal cord.

    abstract::The nasal route is preferred for fiberoptic intubation. Placing a lubricated endotracheal tube through the nostril can guide the fiberoptic scope towards the larynx. It would be helpful for optimal visualization of the vocal cord when the scope is passed through the endotracheal tube if the length of nares-vocal cord ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Han DW,Shim YH,Shin CS,Lee YW,Lee JS,Ahn SW

    更新日期:2005-05-01 00:00:00

  • Postoperative Hypotension and Surgical Site Infections After Colorectal Surgery: A Retrospective Cohort Study.

    abstract:BACKGROUND:Hypotension compromises local tissue perfusion, thereby reducing tissue oxygenation. Hypotension might thus be expected to promote infection. Hypotension on surgical wards, while usually less severe than intraoperative hypotension, is common and often prolonged. In this retrospective cohort study, we tested ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Yilmaz HO,Babazade R,Leung S,Zimmerman NM,Makarova N,Saasouh W,Stocchi L,Gorgun E,Sessler DI,Turan A

    更新日期:2018-11-01 00:00:00

  • An exploration of remifentanil-propofol combinations that lead to a loss of response to esophageal instrumentation, a loss of responsiveness, and/or onset of intolerable ventilatory depression.

    abstract:BACKGROUND:Remifentanil and propofol are increasingly used for short-duration procedures in spontaneously breathing patients. In this setting, it is preferable to block the response to moderate stimuli while avoiding loss of responsiveness (LOR) and intolerable ventilatory depression (IVD). In this study, we explored s...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: LaPierre CD,Johnson KB,Randall BR,White JL,Egan TD

    更新日期:2011-09-01 00:00:00