دورية أكاديمية
Intercostal Nerve Cryoablation or Epidural Analgesia for Multimodal Pain Management after the Nuss Procedure: A Cohort Study.
| العنوان: | Intercostal Nerve Cryoablation or Epidural Analgesia for Multimodal Pain Management after the Nuss Procedure: A Cohort Study. |
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| المؤلفون: | van Braak H; Department of Pediatric Surgery, Amsterdam UMC Locatie AMC, AZ, Amsterdam, Noord-Holland, The Netherlands., de Beer SA; Department of Pediatric Surgery, Amsterdam UMC Locatie AMC, AZ, Amsterdam, Noord-Holland, The Netherlands., de Jong JR; Department of Pediatric Surgery, Amsterdam UMC Locatie AMC, AZ, Amsterdam, Noord-Holland, The Netherlands., Stevens MF; Department of Anesthesiology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands., Musters G; Department of Gastrointestinal Surgery and Surgical Oncology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands., Zwaveling S; Department of Pediatric Surgery, Amsterdam UMC Locatie AMC, AZ, Amsterdam, Noord-Holland, The Netherlands., Oomen MWN; Department of Pediatric Surgery, Amsterdam UMC Locatie AMC, AZ, Amsterdam, Noord-Holland, The Netherlands., der Made WV; Department of Surgery, Leiden Universitair Medisch Centrum, Leiden, Zuid-Holland, The Netherlands., Krug E; Department of Surgery, Leiden Universitair Medisch Centrum, Leiden, Zuid-Holland, The Netherlands., van Heurn LWE; Department of Pediatric Surgery, Amsterdam UMC Locatie AMC, AZ, Amsterdam, Noord-Holland, The Netherlands. |
| المصدر: | European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie [Eur J Pediatr Surg] 2024 Feb 16. Date of Electronic Publication: 2024 Feb 16. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme Country of Publication: United States NLM ID: 9105263 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-359X (Electronic) Linking ISSN: 09397248 NLM ISO Abbreviation: Eur J Pediatr Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York : Thieme Original Publication: Stuttgart : Paris : Hippokrates ; Masson, c1991- |
| مستخلص: | Background: Nuss procedure for pectus excavatum is a minimally invasive, but painful procedure. Recently, intercostal nerve cryoablation has been introduced as a pain management technique. Materials and Methods: In this cohort study, we compared the efficacy of multimodal pain management strategies in children undergoing a Nuss procedure. The effectiveness of intercostal nerve cryoablation combined with patient-controlled systemic opioid analgesia (PCA) was compared with continuous epidural analgesia (CEA) combined with PCA. The study was conducted between January 2019 and July 2022. Primary outcome was length of stay (LOS), and secondary outcomes were operation room time, postoperative pain, opioid consumption, and gabapentin use. Results: Sixty-six consecutive patients were included, 33 patients in each group. The cryoablation group exhibited lower Numeric Rating Scale (NRS) pain scores on postoperative day 1 and 2 ( p = 0.002, p = 0.001) and a shorter LOS (3 vs. 6 days ( p < 0.001). Cryoablation resulted in less patients requiring opioids at discharge (30.3 vs. 97.0%; p < 0.001) and 1 week after surgery (6.1 vs. 45.4%; p < 0.001)). In the CEA group, gabapentin use was more prevalent (78.8 vs. 18.2%; p < 0.001) and the operation room time was shorter (119.4 vs. 135.0 minutes; p < .010). No neuropathic pain was reported. Conclusions: Intercostal nerve cryoablation is a superior analgesic method compared with CEA, with reduced LOS, opioid use, and NRS pain scores. The prophylactic use of gabapentin is redundant. Competing Interests: S.A.B. works as a proctor for cryotherapy in pectus patients contracted by the company Atricure. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).) |
| تواريخ الأحداث: | Date Created: 20240119 Latest Revision: 20240216 |
| رمز التحديث: | 20240217 |
| DOI: | 10.1055/a-2249-7588 |
| PMID: | 38242172 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1439-359X |
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| DOI: | 10.1055/a-2249-7588 |