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Limited cryoablation reduces hospital stay and opioid consumption compared to thoracic epidural analgesia after minimally invasive repair of pectus excavatum

 Seung Hwan Song  ;  Duk Hwan Moon  ;  Yon Hee Shim  ;  Hyunjoo Jung  ;  Sungsoo Lee 
 MEDICINE, Vol.101(31) : e29773, 2022-08 
Journal Title
Issue Date
Adolescent ; Analgesia, Epidural* / methods ; Analgesics, Opioid / therapeutic use ; Cryosurgery* / methods ; Funnel Chest* / surgery ; Humans ; Length of Stay ; Minimally Invasive Surgical Procedures / methods ; Pain, Postoperative / drug therapy ; Pain, Postoperative / surgery ; Retrospective Studies
pain following minimally invasive repair of pectus excavatum (MIRPE) is a critical concern that leads to a prolonged hospital stay and high doses of opiates administered to the patients. This study aimed to evaluate the efficacy of intraoperative cryoanalgesia (cryoablation of the intercostal nerves) during MIRPE. We retrospectively analyzed the data of 64 patients who underwent MIRPE and received cryoanalgesia or epidural analgesia between January 2019 and January 2021. The oral morphine milligram equivalent (MME) was used to calculate the dosage of opioid agents. The median age was 15 years (range, 4-33 years). The median postoperative hospital stay was 4 days (range, 2-6 days), with a median oral MME consumption of 45 mg (ranging from 0 to 1360 mg). Cryoanalgesia was performed in 38 patients, and epidural analgesia was administered to the remaining 26 patients. The cryoanalgesia group had a significantly lesser pain score, shorter postoperative hospital stay and lower oral MME consumption than the epidural analgesia group (5 vs 2; P < .001, 3 days vs 5 days; P < .001, 19 mg vs 634 mg; P < .001). Cryoanalgesia appears to reduce postoperative hospital stay and opioid consumption compared with epidural analgesia. The outcomes of this study indicate that cryoanalgesia might be a safe and effective method for pain control following MIRPE.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Duk Hwan(문덕환)
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Lee, Sung Soo(이성수) ORCID logo https://orcid.org/0000-0001-8998-9510
Jung, Hyunjoo(정현주)
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