Chronic pain in children after cardiac surgery via sternotomy

Introduction: Chronic pain is common after sternotomy in adults with reported prevalence rates of 20-50%. So far, no studies have examined whether children develop chronic pain after sternotomy. Material and methods: Postal questionnaires were sent to 171 children 10-60 months after undergoing cardiac surgery via sternotomy at the age of 0-12 years. The children were asked to recall the intensity and duration of their post-operative pain, if necessary with the help from their parents, and to describe the intensity and character of any present pain. Another group of 13 children underwent quantitative sensory testing of the scar area 3 months after sternotomy. Results: A total of 121 children, median (range) age 7.7 (4.2-16.9) years, answered the questionnaire. Their age at the time of surgery was median (range) 3.8 (0-12.9) years, and the follow-up period was median (range) 4 (0.8-5.1) years. In all, 26 children (21%) reported present pain and/ or pain within the last week located in the scar area; in 12 (46%) out of the 26 children, the intensity was >= 4 on a numeric rating scale (0-10). Quantitative sensory testing of the scar area revealed sensory abnormalities pinprick hyperalgesia and brush and cold allodynia - in 10 out of 13 children. Conclusion: Chronic pain after cardiac surgery via sternotomy in children is a problem that should not be neglected. The pain is likely to have a neuropathic component as suggested by the sensory abnormalities demonstrated by quantitative sensory testing.