Same day discharge for pectus excavatum—is it possible?
Topic overview
Prospective study demonstrates that same-day discharge is feasible for pectus excavatum Nuss repair when combining intercostal nerve cryoablation with nerve blocks and ERAS protocols. Two-thirds of patients went home on postoperative day 0 with adequate pain control, and 67% required no opioids after discharge.
Key takeaways
- Same-day discharge after Nuss procedure is feasible in 67% of pectus excavatum patients when combining intercostal nerve cryoablation with nerve block.
- Pain was not a barrier to discharge; failures were due to urinary retention, drowsiness, vomiting, or anxiety—not inadequate analgesia.
- Two-thirds of patients required no opioids after discharge when cryoablation and nerve blocks were used for pain control.
- Enhanced recovery protocols with cryoablation enable average hospital stay of 12 hours without increased ED visits or readmissions.
- Bar migration remains a risk (1/15 patients) requiring return to OR, independent of the accelerated discharge pathway.
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