Intercostal nerve cryoablation is associated with lower hospital cost during minimally invasive Nuss procedure for pectus excavatum.
J Pediatr Surg
; 56(10): 1841-1845, 2021 Oct.
Article
em En
| MEDLINE
| ID: mdl-33199059
ABSTRACT
Minimally invasive repair of pectus excavatum (Nuss procedure) is associated with significant pain, and efforts to control pain impact resource utilization. Bilateral thoracic intercostal nerve cryoablation has been proposed as a novel technique to improve post-operative pain control, though the impact on hospital cost is unknown. METHODS:
We conducted a retrospective study of patients undergoing a Nuss procedure from 2016 to 2019. Patients who received cryoablation were compared to those that received traditional pain control (patient-controlled analgesia or epidural). Outcome variables included postoperative opioid usage (milligram morphine equivalents, MME), length of stay (LOS), and hospital cost.RESULTS:
Thirty-five of 73 patients studied (48%) received intercostal nerve cryoablation. LOS (1.0 vs 4.0â¯days, pâ¯<â¯0.01) and total hospital cost ($21,924 versus $23,694, pâ¯=â¯0.04) were decreased in the cryoablation cohort, despite longer operative time (152 vs 74â¯min, pâ¯<â¯0.01). Cryoablation was associated with decreased opioid usage (15.0 versus 148.6 MME, pâ¯<â¯0.01) during the 24â¯h following surgery and this persisted over the entire postoperative period, including discharge opioid prescription (112.5 vs 300.0 MME, pâ¯<â¯0.01).CONCLUSION:
Bilateral intercostal nerve cryoablation is associated with decreased postoperative opioid usage and decreased resource utilization in pediatric patients undergoing a minimally invasive Nuss procedure for pectus excavatum. LEVEL OF EVIDENCE Retrospective comparative study, level III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Criocirurgia
/
Tórax em Funil
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
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Observational_studies
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Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article