Intercostal nerve cryoablation versus thoracic epidural catheters for postoperative analgesia following pectus excavatum repair: Preliminary outcomes in twenty-six cryoablation patients.
J Pediatr Surg
; 51(12): 2033-2038, 2016 Dec.
Article
en En
| MEDLINE
| ID: mdl-27745867
ABSTRACT
BACKGROUND:
Multimodal pain management strategies are used for analgesia following pectus excavatum repair. However, the optimal regimen has not been identified. We describe our early experience with intercostal cryoablation for pain management in children undergoing the Nuss procedure and compare early cryoablation outcomes to our prior outcomes using thoracic epidural analgesia.METHODS:
A multi-institutional, retrospective review of fifty-two patients undergoing Nuss bar placement with either intercostal cryoablation (n=26) or thoracic epidural analgesia (n=26) from March 2013 to January 2016 was conducted. The primary outcome was hospital length of stay. Secondary outcomes included telemetry unit monitoring time, total intravenous narcotic use, duration of intravenous narcotic use, and postoperative complications.RESULTS:
Patients who underwent intercostal cryoablation had a significant reduction in the mean hospital length of stay, time in a monitored telemetry bed, total use of intravenous narcotics, and the duration of intravenous narcotic administration when compared to thoracic epidural patients. Cryoablation patients had a slightly higher rate of postoperative complications.CONCLUSION:
Intercostal cryoablation is a promising technique for postoperative pain management in children undergoing repair of pectus excavatum. This therapy results in reduced time to hospital discharge, decreased intravenous narcotic utilization, and has eliminated epidurals from our practice. LEVEL OF EVIDENCE Retrospective study - level III.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Analgesia Epidural
/
Criocirugía
/
Tórax en Embudo
/
Nervios Intercostales
Tipo de estudio:
Observational_studies
Límite:
Adolescent
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Pediatr Surg
Año:
2016
Tipo del documento:
Article