こどもの慢性痛―外来開設とその展望―

Chronic Pain in Children：Establishment of an Outpatient Clinic and its Prospects

要旨

　こどもの慢性痛の頻度は20-30％以上と報告されているが，認知度は低い。こどもの慢性痛は心理・社会的要因が痛みの難治化に影響していることが多い。治療は生理学的・心理学的・社会的要因を考慮した多面的アプローチが必要である。心身ともに発達段階であるこどもの疼痛行動に含まれる象徴的意味を理解し，配慮することで，不登校や抑うつなど二次的障害を予防する必要がある。当院は2021年12月にこどもの痛み外来を開設し，多職種・多面的治療を行っている。わが国は，こどもの慢性痛に対する理解がいまだ十分ではない。より多くの麻酔科医が，こどもの慢性痛について理解し，ケアを担っていくことが望まれる。

　The prevalence of child’s chronic pain is 20-30％, although such pain is not sufficiently recognized. Child’s chronic pain causes difficulties with school life, depression, school refusal, social isolation, growth impairment, and low QOL. In addition, two-thirds of child’s chronic pain persist to adulthood, thus markedly affecting their growth and development. Psychological and social factors often complicate its treatment. A multidisciplinary approach should be employed for the treatment in view of physiological, psychological, and social factors. It is necessary to understand and take into account the symbolic meanings contained in the pain behaviour of children who are still in the developmental stage both mentally and physically, in order to prevent secondary disorders such as non-attendance at school and depression. Our hospital established an outpatient pain clinic for children in December 2021 to treat child’s chronic pain using a multidisciplinary approach. We herein introduce our efforts and its prospects.