Abstract
Purpose: Pain control is challenging after minimally invasive repair of pectus excavatum (MIRPE). Cryoanalgesia, which temporarily ablates peripheral nerves, improves pain control and may accelerate post-operative recovery. We hypothesized that cryoanalgesia would be associated with shorter length of stay (LOS) in children undergoing MIRPE. Methods: A matched cohort study was conducted of children (<18 years) who underwent MIRPE 2016–2018, using the National Surgical Quality Improvement Program-Pediatric database. Each patient who received cryoanalgesia during MIRPE was matched to four controls (no cryoanalgesia). Univariate and multilevel regression analyses were performed. Results: Thirty-five patients who received cryoanalgesia during MIRPE were matched to 140 controls. Patients who received cryoanalgesia had a LOS reduction with similar secondary outcomes (operative time, rates of complication, reoperation, and readmission). On multilevel regression adjusted for matched groups, cryoanalgesia was associated with a 1.3-day reduction in LOS (95% CI −1.8 to −0.8, p < 0.001). On sensitivity analysis excluding patients with complications, cryoanalgesia remained associated with a LOS reduction. Conclusions: Cryoanalgesia is a promising adjunct in the care of pediatric patients undergoing MIRPE. Utilization is associated with a shorter LOS without an increase in operative time or complications. Cryoanalgesia should be considered for inclusion in enhanced recovery strategies for patients undergoing MIRPE.
Original language | English (US) |
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Pages (from-to) | 1099-1102 |
Number of pages | 4 |
Journal | Journal of pediatric surgery |
Volume | 56 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2021 |
Keywords
- Cryoanalgesia
- Length of stay
- Minimally invasive repair of pectus excavatum
- Nuss procedure
- Pain control
- Pectus excavatum
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Surgery