Short and Long Term Outcomes of Using Cryoablation for Postoperative Pain Control in Patients after Pectus Excavatum Repair
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In brief
In brief
This three-year prospective study of 110 patients evaluates intercostal nerve cryoablation for pain control after minimally invasive pectus excavatum repair. While cryoablation proved effective, 55% reported residual pain at two weeks and 25% required pain medication at three months, with patients frequently underreporting functional limitations.
Written by the GCMD Library team from the article.
Introduction
: We report the findings of a three-year prospective observational study elucidating long-term symptoms and complications of patients who underwent minimally invasive pectus excavatum repair with intercostal nerve cryoablation with specific attention to postoperative pain control associated with the cryoablation technique.
Methods
: Surveys were administered to patients who underwent bar placement for pectus excavatum with intercostal nerve cryoablation from 2017-2021 regarding pain scores, pain medication usage, and limitations to activity beginning on the day of surgery, on the day of discharge, and at two-week and three-month follow-up.
Results
: Of 110 patients, forty-eight (44%) completed the discharge survey; sharp pain and pressure on the first postoperative night were the most described pain characteristics, most frequently in the middle of the chest. On follow-up, 55% of patients reported tolerable residual pain at two weeks and 41% at three months, with 25% requiring intermittent pain medication at three months. There were three readmissions for inadequate pain control and 110 calls to the surgery clinic by three-month follow-up, most commonly for persistent pain and frequent popping sensation with movement.
Discussion
: Although cryoablation is an excellent pain control modality, these data suggest that patients underreport functional symptoms and experience more frequent discomfort and alteration of daily living activities.
Level of Evidence
: II – prospective cohort study