Use of cryoanalgesia for pain management for the modified ravitch procedure in children.
J Pediatr Surg
; 55(7): 1381-1384, 2020 Jul.
Article
en En
| MEDLINE
| ID: mdl-31672412
ABSTRACT
BACKGROUND:
Intercostal cryoablation(IC) for pain management in children undergoing Nuss Procedure has been previously described. We evaluated postoperative outcomes following Modified Ravitch procedure for pectus disorders comparing IC to thoracic epidural(TE). MATERIALS ANDMETHODS:
Single-center retrospective review of pediatric patients (ageâ¯<â¯21) undergoing Modified Ravitch procedure (January 2015-March 2019) with either IC(9), or TE(20) analgesia. Primary outcome was length of stay (LOS) and secondary outcomes were inpatient opioid use (in oral morphine equivalents per kilogram; OME/kg), pain scores on each postoperative day (POD), discharge prescriptions, and complications. Pairwise comparisons made with Mann-Whitney U test or Fisher Exact test as appropriate. Two-tailed p values <0.05 were considered significant.RESULTS:
Patient characteristics were similar. LOS was shorter with IC compared to TE (4â¯days versus 6; pâ¯<â¯0.006). Postoperative opioid use was not significantly different (IC 1.5 OME/kg versus TE 1.1; pâ¯=â¯0.10). There was improved pain control on POD 2 in patients who underwent IC (median pain score 3 versus 4; pâ¯<â¯0.0004). There was no difference in discharge prescription (IC 3.3 OME/kg; TE 4.8; pâ¯=â¯0.19) or complication rate (IC 55.6%, TE50%; pâ¯=â¯1.0).CONCLUSIONS:
IC during the Modified Ravitch reduced LOS compared to TE with improved pain control starting on POD 2, with similar narcotic utilization and complication rates. LEVEL OF EVIDENCE Treatment Study, Level III (Retrospective comparative study).Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Crioterapia
/
Manejo del Dolor
/
Tórax en Embudo
Tipo de estudio:
Observational_studies
Límite:
Adolescent
/
Adult
/
Child
/
Humans
Idioma:
En
Revista:
J Pediatr Surg
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos