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Pediatric Surgery International

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01-03-2020 | Neuropathic Pain | Original Article

The incidence of neuropathic pain after intercostal cryoablation during the Nuss procedure

Authors: Michael J. Zobel, Clifton Ewbank, Roberta Mora, Olajire Idowu, Sunghoon Kim, Benjamin E. Padilla

Published in: Pediatric Surgery International | Issue 3/2020

Abstract

Purpose

Intercostal nerve cryoblation during the Nuss procedure for pectus excavatum decreases pain, opiate requirement, and hospital length of stay (LOS) compared to thoracic epidural analgesia. However, long-term complications of cryoablation, including neuropathic pain development, are not well studied.

Methods

We conducted a multi-institutional retrospective review of patients following intercostal nerve cryoablation during Nuss bar insertion (11/2015–7/2018). Patients completed the Leeds Assessment of Neuropathic Symptoms and Signs, a validated questionnaire for detecting neuropathic symptoms. Primary outcome was neuropathic pain development. Secondary outcomes included duration of chest numbness and LOS. T test was performed; p < 0.05 is significant.

Results

43 patients underwent intercostal cryoablation during the Nuss procedure. Ages at repair ranged 11–47 years (median 16). Patients were grouped by age: ≤ 21 years (30 patients) or older (13 patients). Mean LOS was shorter for the younger group, 2.0 versus 3.9 days (p = 0.03). No patients in the younger group, and three in the older, experienced neuropathic pain. Mean time to numbness resolution was shorter for the younger group, 3.4 versus 10.8 months (p = 0.003).

Conclusion

In pediatric patients, intercostal cryoablation provides effective analgesia following the Nuss procedure with minimal risk of post-operative neuropathic pain. Adult patients are at greater risk of experiencing neuropathic pain and prolonged numbness.

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Title: The incidence of neuropathic pain after intercostal cryoablation during the Nuss procedure
Authors: Michael J. Zobel
Clifton Ewbank
Roberta Mora
Olajire Idowu
Sunghoon Kim
Benjamin E. Padilla
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Neuropathic Pain
Gabapentin
Published in: Pediatric Surgery International / Issue 3/2020
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-019-04602-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The incidence of neuropathic pain after intercostal cryoablation during the Nuss procedure

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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