Management of chronic pain in children and young people: summary

A summary of the available evidence, combined with a consensus group agreement on key recommendations and suggested patient pathways.


Appendix 3: Search Strategies

Guideline topic: Paediatric Chronic Pain

General comments

The systematic literature search involved searching for evidence for 13 questions.

Systematic reviews were identified for all questions by using a generic stem search strategy combined with a filter for systematic reviews.

Primary literature studies were identified for 6 questions (1, 5, 6, 7, 8, 13) by combining the generic stem search with a search strategy for each individual question.

Search coverage

Systematic reviews
Databases covered: Medline,
Embase, CINAHL, PsycINFO,
Cochrane

Dates covered: to 14 Jul 2015

Total hits: 483

Sifted result: 59

Papers requested: 55

Primary literature

Databases covered: Medline,
Embase, CINAHL, PsycINFO,
Cochrane

Dates covered: (with variations
depending on topic; see Scope
of Searches below)

Total hits: see table
below

Sifted result: see table below

Papers requested:

Search strategies

The following are listings of the main Medline strategies used for this guideline. All conventions and symbols are from the Ovid implementation of Medline. Strategies used in other databases were substantially the same, though different terminology may have been used to take account of different thesauri used in non-Medline databases.

Search filters were added to identify studies of a particular type (systematic review, RCT etc.) Listings of the search filters used by SIGN can be found on the SIGN website.

Generic Stem:

Medline Generic stem

1. exp Chronic Pain/
2. exp Pain/
3. exp Chronic Disease/
4. 2 and 3
5. (chronic adj5 pain).tw.
6. (persist* adj3 pain).tw.
7. (long* adj3 pain).tw.
8. (paediatric* adj5 pain).tw.
9. (pediatric* adj5 pain).tw.
10. exp Complex Regional Pain Syndromes/
11. CRPS.tw.
12. (pain adj3 syndrome*).tw.
13. (complex adj3 pain).tw.
14. (recurrent adj3 pain).tw.
15. Fibromyalgia/
16. fibromyalgia*.tw.
17. or/4-16
18. 1 or 17
19. limit 18 to ("all infant (birth to 23 months)" or "all child (0 to 18 years)" or "newborn infant (birth to 1 month)" or "infant (1 to 23 months)" or "preschool child (2 to 5 years)" or "child (6 to 12 years)" or "adolescent (13 to 18 years)")
20. Adolescent/
21. exp Child/
22. exp Infant/
23. adolescen*.tw.
24. teenager*.tw.
25. (teen or teens).tw.
26. child*.tw.
27. infant*.tw.
28. (baby or babies).tw.
29. toddler*.tw.
30. (pre-schooler* or preschooler or schoolchild*).tw.
31. (girl* or boy*).tw.
32. or/20-31
33. 18 and 32
34. 19 or 33

Scope of searches for Primary literature searches ( NOF = no filter search ie no study type filters applied)

KQ Type of studies Date range Initial recall Sifted result
1 NOF To 18/01/16 1021 19
5 NOF To 04/12/15 602 28
6 NOF To 04/12/15 797 23
7 NOF To 10/12/15 762 37
8 NOF To 16/12/15 445 24
13 NOF 2006-18/01/2016 1881 62

Medline Search strategies used for specific key questions:

KQ 1

1. "Referral and Consultation"/
2. (early adj5 refer*).tw.
3. (late adj refer*).tw.
4. (timing adj5 refer*).tw.
5. (time adj5 refer*).tw.
6. (early adj5 treatment*).tw.
7. (late adj5 treatment*).tw.
8. (timing adj5 treatment*).tw.
9. (time adj5 treatment*).tw.
10. (early adj5 intervention*).tw.
11. (late adj5 intervention*).tw.
12. (timing adj5 intervention*).tw.
13. (time adj5 intervention*).tw.
14. Early Diagnosis/
15. (earl* adj5 diagnos*).tw.
16. (earl* adj5 detection).tw.
17. Critical Pathways/
18. (clinical adj5 (pathway* or journ*)).tw.
19. (care adj5 (pathway* or journ*)).tw.
20. or/1-19

KQ 5

1. exp Anticonvulsants/
2. (anticonvulsant* or anti-convulsant*).tw.
3. (antiepileptic* or anti-epileptic*).tw.
4. gabapentin*.tw.
5. pregabalin*.tw.
6. exp Valproic Acid/
7. sodium valproate*.tw.
8. exp Carbamazepine/
9. carbamazepine*.tw.
10. oxcarbazepine*.tw.
11. oxcarbamazepine*.tw.
12. topiramate*.tw.
13. lamotrigine*.tw.
14. lacosamide*.tw.
15. levotiracetam*.tw.
16. or/1-15

KQ 6

1. exp Analgesics/
2. exp Administration, Topical/
3. 1 and 2
4. exp Lidocaine/
5. exp Capsaicin/
6. exp Clonidine/
7. exp Transdermal Patch/
8. exp Ointments/
9. or/4-8
10. (topical* or transdermal or cream* or patch* or ointment*).tw.
11. 3 or 9 or 10

KQ 7

1. exp Antidepressive Agents/
2. exp Serotonin Uptake Inhibitors/
3. exp Lithium/
4. lithium*.tw.
5. duloxetine*.tw.
6. mirtazapine*.tw.
7. venlafaxine*.tw.
8. fluoxetine*.tw.
9. citalopram*.tw.
10. amitriptyline*.tw.
11. nortriptyline*.tw.
12. clomipramine*.tw.
13. imipramine*.tw.
14. (antidepressant* or antidepressive*).tw.
15. (selective adj3 inhibitor*).tw.
16. ( SSRI* or SNRI*).tw.
17. or/1-16

KQ 8

1. Ketamine/
2. exp Cannabinoids/
3. Baclofen/
4. Clonidine/
5. Diazepam/
6. ketamine*.tw.
7. cannabinoid*.tw.
8. nabilone*.tw.
9. THC.tw.
10. tetrahydrocannabinol*.tw.
11. baclofen*.tw.
12. clonidine.tw.
13. diazepam.tw.
14. Marijuana Smoking/
15. marijuana*.tw.
16. or/1-15

KQ 13

1. General Surgery/
2. Surgical Procedures, Operative/
3. surgery.tw.
4. exp Sympathectomy/
5. sympathectom*.tw.
6. Rhizotomy/
7. rhizotom*.tw.
8. exp Nerve Block/
9. nerve block*.tw.
10. biers block.tw.
11. ganglion block.tw.
12. plexus block.tw.
13. exp Botulinum Toxins/
14. botox.tw.
15. exp Electric Stimulation Therapy/
16. neuromodulation.tw.
17. exp Analgesia, Epidural/
18. exp Anesthesia, Epidural/
19. exp Injections, Epidural/
20. epidural.tw.
21. caudal.tw.
22. or/1-21
23. trigger point*.tw.
24. exp Injections/
25. injection*.tw.
26. 23 and (24 or 25)
27. 22 or 26

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