Enhanced Recovery After Surgery 2.0: Optimizing Pain Management in Nuss Procedure: Cryoablation and Nerve Block Strategies for Reduced Opioid Use

Our study assesses the association between cryoablation, with and without nerve block supplementation, post-Nuss procedure pain, and opioid use in pectus excavatum (PE) patients. We conducted a retrospective cohort study at a single center for PE patients who underwent the Nuss procedure from 2017 t...

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Bibliographic Details
Published in:The Journal of surgical research 2024-09, Vol.301, p.563-571
Main Authors: Wharton, Kristin, Chidiac, Charbel, Lopez, Carla, Hunsberger, Joann, Rhee, Daniel, Cappiello, Clint, Garcia, Alejandro V.
Format: Article
Language:English
Subjects:
Cryoablation
Enhanced recovery after surgery (ERAS)
Nerve blocks
Nuss procedure
Pectus excavatum
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Summary:Our study assesses the association between cryoablation, with and without nerve block supplementation, post-Nuss procedure pain, and opioid use in pectus excavatum (PE) patients. We conducted a retrospective cohort study at a single center for PE patients who underwent the Nuss procedure from 2017 to 2022. Outcomes included postoperative opioid use (measured in oral morphine milligram equivalent per kilogram [OME/kg]), average pain score (scale 0-10), and length of stay (LOS). One hundred sixty-four patients (146 males and 18 females) were included, with 79 (48.2%) receiving neither cryoablation nor nerve block, 60 (36.6%) receiving intraoperative cryoablation alone, and 25 (15.2%) receiving both cryoablation and nerve block. The median age was 16 y. Nerve block recipients consumed fewer opioids during hospitalization than cryoablation alone and nonintervention groups (1.5 versus 2.3 versus 5.8 OME/kg, respectively, P 
ISSN:0022-4804
1095-8673
1095-8673
DOI:10.1016/j.jss.2024.07.003