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01-01-2021 | Opioids | Original Article

Cryoablation is associated with shorter length of stay and reduced opioid use in pectus excavatum repair

Authors: R. Luke Rettig, Andrew G. Rudikoff, Hoi Yee Annie Lo, Donald B. Shaul, Franklin M. Banzali, Antonio Hernandez Conte, Roman M. Sydorak

Published in: Pediatric Surgery International | Issue 1/2021

Abstract

Purpose

The use of intercostal nerve cryoablation (INC) is becoming increasingly common in patients undergoing pectus excavatum (PE) repair. This study sought to evaluate the use of INC compared to traditional use of thoracic epidural (TE).

Methods

A retrospective review of 79 patients undergoing PE repair with either INC or TE from May 2009 to December 2019 was conducted. The operations were performed by four surgeons who worked together at four different hospitals and have the same standardized practice. The primary outcome measure was hospital length of stay (LOS). Secondary variables included surgical time, total operating room time, operating room time cost, total hospital cost, inpatient opioid use, long-term opioid use after discharge, and postoperative complications.

Results

LOS decreased to 2.5 days in the INC group compared to 5 days in the TE group (p < 0.0001). Surgical time was increased in the INC group, but there was no difference in total OR time. The INC group experienced significantly lower hospital costs. Total hospital opioid administration was significantly lower in INC group, and there was a significant decrease in long-term opioid use in the INC group.

Conclusions

INC is a newer modality that decreases LOS, controls pain, and results in overall cost savings. We recommend that INC be included in the current practice for postoperative pain control in PE patients undergoing Nuss procedure.

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Title: Cryoablation is associated with shorter length of stay and reduced opioid use in pectus excavatum repair
Authors: R. Luke Rettig
Andrew G. Rudikoff
Hoi Yee Annie Lo
Donald B. Shaul
Franklin M. Banzali
Antonio Hernandez Conte
Roman M. Sydorak
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Opioids
Opioids
Published in: Pediatric Surgery International / Issue 1/2021
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04778-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cryoablation is associated with shorter length of stay and reduced opioid use in pectus excavatum repair

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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