Pilot Investigation of Somatosensory Functioning and Pain Catastrophizing in Pediatric Spinal Fusion Surgery

Purpose: Chronic post-surgical pain (CPSP) is a significant concern and contributes to the opioid epi-demic; however, little is known about CPSP in young people. Design: This prospective study aimed to identify sensory, psychological, and demographic factors that may increase the risk of CPSP after spinal fusion surgery for children and adolescents with idiopathic scoliosis. Methods: 32 children and adolescents from two children's hospitals completed quantitative sensory test-ing (QST) and the Pain Catastrophizing Scale Child (PCS-C) pre-and 4-6 months post spinal fusion surgery. Between-group differences were assessed using an independent samples t-test. Pearson's correlations and stepwise linear regression were used to assess the relationship between variables at both time points. Results: 56% of patients endorsed pain post-surgery. They were more sensitive to mechanical detection on both a control non-pain site (r =-2.87, p = .004) and the back (r =-1.83, p = .04), as well as pressure pain (r = -2.37, p = .01) on the back. This group also reported worse pain scores pre-surgery. Pre-surgery helplessness positively correlated with preoperative pain (r = .67 p < .001), and age was negatively corre-lated with the post-surgical catastrophizing total score (r =-.39, p = .05), suggesting that younger patients endorsed more pain-related worry after surgery. Conclusions: Patients who present with pain during their preoperative appointment may need to be monitored with increased vigilance throughout the perioperative period, possibly with bedside QST and psychological questionnaires, which nurses could administer. Biobehavioral interventions targeting pain intensity and feelings of helplessness and anxiety during the preoperative period may alleviate the tran-sition to CPSP. (c) 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.