Intercostal nerve cryoablation during surgical stabilization of rib fractures decreases post-operative opioid use, ventilation days, and intensive care days

•Cryoablation provides lasting nerve blockade and improves outcomes during rib fixation.•This retrospective study analyzed outcomes during SSRF with and without cryoablation.•Cryoablated patients required less post-operative total, daily, and discharge MME.•No increase in pulmonary complications or...

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Bibliographic Details
Published in:Injury 2023-09, Vol.54 (9), p.110803-110803, Article 110803
Main Authors: Marturano, Matthew N, Thakkar, Vandan, Wang, Huaping, Cunningham, Kyle W, Lauer, Cynthia, Sachdev, Gaurav, Ross, Samuel W, Jordan, Mary M, Dieffenbaugher, Sean T, Sing, Ronald F, Thomas, Bradley W
Format: Article
Language:English
Subjects:
cryoablation
morbidity
opioid
pain
Rib Fractures
trauma
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Summary:•Cryoablation provides lasting nerve blockade and improves outcomes during rib fixation.•This retrospective study analyzed outcomes during SSRF with and without cryoablation.•Cryoablated patients required less post-operative total, daily, and discharge MME.•No increase in pulmonary complications or operative time with cryoablation. Intercostal nerve cryoablation is an adjunctive measure that has demonstrated pain control, decrease in opioid consumption, and decrease in hospital length of stay (LOS) in patients who undergo surgical stabilization of rib fractures (SSRF). SSRF patients from January 2015 to September 2021 were retrospectively compared. All patients received multimodal pain regimens post-operatively and the independent variable was intraoperative cryoablation. 241 patients met inclusion criteria. 51 (21%) underwent intra-operative cryoablation during SSRF and 191 (79%) did not. Patients with standard treatment consumed 9.4 more daily MME (p = 0.035), consumed 73 percent more post-operative total MME (p = 0.001), spent 1.55 times as many days in the intensive care unit (p = 0.013), and spent 3.8 times as many days on the ventilator than patients treated with cryoablation, respectively. Overall hospital LOS, operative case time, pulmonary complications, MME at discharge, and numeric pain scores at discharge were no different (all p>0.05). Intercostal nerve cryoablation during SSRF is associated with fewer ventilator days, ICU LOS, total post-operative, and daily opioid use without increasing time in the operating room or perioperative pulmonary complications.
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2023.05.034