Same-Day Discharge Following the Nuss Repair: A Comparison
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Read the article on jpedsurg.org ↗Article · Sep 2021 · 1 min read
In brief
In brief
Study compares outcomes of Nuss repair for pectus excavatum using intercostal nerve cryoablation alone versus a multimodal ERAS protocol with cryoablation and nerve blocks. The enhanced protocol reduced mean hospital stay from 58.2 to 11.8 hours, enabling safe same-day discharge for pediatric patients.
Written by the GCMD Library team from the article.
Purpose
Intercostal Nerve Cryoablation (INC) has significantly improved pain control following the Nuss repair of pectus excavatum (PE). This study sought to evaluate patients undergoing the Nuss repair with INC compared to the Nuss repair with an ERAS protocol, INC, and intercostal nerve blocks (INB).
Methods
In June 2020, a new protocol was implemented involving surgery, anesthesia, nursing, physical therapy, and child life with the goal of safe same day discharge for patients undergoing the Nuss repair. They were compared to a control group who underwent the Nuss repair with INC alone in 2017-2019. The primary outcome measure was hospital length of stay (LOS) in hours, secondary outcomes were number of patients discharged on postoperative day (POD) 0, and returns to the emergency department (ED), urgent care (UC), and operating room (OR).
Results
The characteristics between the groups were the same (Table 1). The mean LOS was 11.8 hours in the INB group versus 58.2 hours in the INC group, p