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A Systematic Review of Assessments and Interventions for Chronic Pain in Young Children With or at High Risk for Cerebral Palsy
Journal of Child Neurology ( IF 1.9 ) Pub Date : 2021-03-09 , DOI: 10.1177/0883073821996916
Lisa Letzkus 1 , Darcy Fehlings 2 , Lauren Ayala 3 , Rachel Byrne 4 , Alison Gehred 5 , Nathalie L Maitre 6, 7 , Garey Noritz 6 , Nathan S Rosenberg 6 , Kelly Tanner 8 , Jilda Vargus-Adams 9 , Sarah Winter 3 , Dennis J Lewandowski 7 , Iona Novak 10
Affiliation  

Background:

Pain is common in children with cerebral palsy. The purpose of this systematic review was to evaluate the evidence regarding assessments and interventions for chronic pain in children aged ≤2 years with or at high risk for cerebral palsy.

Methods:

A comprehensive literature search was performed. Included articles were screened using PRISMA guidelines and quality of evidence was reviewed using best-evidence tools by independent reviewers. Using social media channels, an online survey was conducted to elicit parent preferences.

Results:

Six articles met criteria. Parent perception was an assessment option. Three pharmacologic interventions (gabapentin, medical cannabis, botulinum toxin type A) and 1 nonpharmacologic intervention were identified. Parent survey report parent-comfort and other nonpharmacologic interventions ranked as most preferable.

Conclusion:

A conditional GRADE recommendation was in favor of parent report for pain assessment. Clinical trials are sorely needed because of the lack of evidence for safety and efficacy of pharmacologic interventions.



中文翻译:

对脑瘫或脑瘫高危儿童慢性疼痛评估和干预的系统评价

背景:

疼痛在脑瘫儿童中很常见。本系统评价的目的是评估有关评估和干预年龄≤2 岁脑瘫或脑瘫高风险儿童慢性疼痛的证据。

方法:

进行了全面的文献检索。纳入的文章使用 PRISMA 指南进行筛选,证据质量由独立评审员使用最佳证据工具进行评审。使用社交媒体渠道进行了一项在线调查,以了解家长的偏好。

结果:

六篇文章符合标准。父母的看法是一个评估选项。确定了三种药物干预(加巴喷丁、医用大麻、A 型肉毒杆菌毒素)和一种非药物干预。家长调查报告称,家长舒适度和其他非药物干预措施最为可取。

结论:

有条件的 GRADE 建议支持家长报告疼痛评估。由于缺乏药物干预的安全性和有效性证据,因此迫切需要临床试验。

更新日期:2021-03-10
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