{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:38:00Z","timestamp":1787625480946,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T00:00:00Z","timestamp":1593043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Minimally invasive repair of pectus excavatum (MIRPE) is associated with less tissue trauma; however, it may result in increased postoperative pain. Pain experience is a known risk factor for the development of posttraumatic stress symptoms, though there are little data on its relationship with long\u2010term psychological outcomes following major surgery in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>In this study, we examined the relationship between immediate postoperative pain and psychological outcomes at 2\u00a0weeks and three months after discharge in a cohort of pediatric patients who underwent MIRPE. We sought to determine whether immediate postoperative pain levels were associated with ongoing distress related to aspects of surgery at both time points. We were also interested in how psychological symptoms related to persistent pain concerns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on patients undergoing MIRPE across 14 institutions were collected as part of the Society for Pediatric Anesthesia Improvement Network (SPAIN). Patients were contacted at 2\u00a0weeks and three months following discharge to track pain levels and assess psychological distress using a self\u2010report questionnaire. Patients were grouped into cohorts based on self\u2010report of distress related to aspects of surgery, nonsurgical distress, or absence of distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis revealed that a higher proportion of children reporting ongoing distress related to surgery at both 2\u00a0weeks and 3\u00a0months experienced higher immediate postoperative pain levels. A subset of patients with complete data sets for 2\u00a0weeks and 3\u00a0months (N\u00a0=\u00a076) was further examined. Among the 47 patients who endorsed surgical distress at 2\u00a0weeks, 25 (53.2%) continued to endorse surgical distress at 3\u00a0months. Additionally, report of surgical distress at 3\u00a0months was associated with longer\u2010term postoperative pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data suggest that, in patients undergoing MIRPE, the presence of distress at 2\u00a0weeks and 3\u00a0months may be associated with higher immediate postoperative pain levels.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13942","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T16:34:20Z","timestamp":1591202060000},"page":"1006-1012","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Postoperative pain and psychological outcomes following minimally invasive pectus excavatum repair: A report from the Society for Pediatric Anesthesia Improvement Network"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0420-5874","authenticated-orcid":false,"given":"Kristen M.","family":"Uhl","sequence":"first","affiliation":[{"name":"Department of Psychosocial Oncology and Palliative Care Dana Farber Cancer Institute  Boston \u200eMassachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Wilder","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine Mayo Clinic College of Medicine and Science  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5698-7797","authenticated-orcid":false,"given":"Allison","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Johns Hopkins All Children's Hospital Johns Hopkins University School of Medicine  St. Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Texas Children's Hospital Baylor 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