Same day discharge for pectus excavatum—is it possible?
| Autor: | R. Luke Rettig, Roman M. Sydorak, Karen Rodriguez, Antonio Hernandez Conte, Constance W. Lee, Franklin M. Banzali, Andrew G. Rudikoff, Walter D. Vazquez, Hoi Yee Annie Lo, Donald B. Shaul |
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| Rok vydání: | 2022 |
| Předmět: |
Pain
Postoperative medicine.medical_specialty Constipation Urinary retention business.industry General Medicine Emergency department medicine.disease Nuss procedure Patient Discharge Surgery Pectus excavatum Funnel Chest Pediatrics Perinatology and Child Health medicine Vomiting Humans Prospective Studies medicine.symptom Prospective cohort study business Retrospective Studies Intercostal nerve block |
| Zdroj: | Journal of Pediatric Surgery. 57:34-38 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2021.02.007 |
| Popis: | Purpose The use of intercostal nerve cryoablation (INC) has been an effective modality for treating pain in patients undergoing pectus excavatum (PE) repair. This study sought to evaluate if PE patients undergoing Nuss procedures with INC and intercostal nerve block (INB) could safely be discharged the same day of surgery. Methods A prospective study with IRB approval of 15 consecutive patients undergoing PE Nuss repair with INC, INB, and an enhanced recovery after surgery (ERAS) protocol was conducted. The primary outcome measure was hospital length of stay (LOS) in hours. Secondary variables included same day discharge, postoperative complications, emergency department (ED) visits, urgent care (UC) visits, opioid use, and return to the operating room (OR). Results LOS averaged 11.9 h amongst 15 patients. Ten patients (66.7%) went home on postoperative day (POD) 0, and the rest went home on POD 1. No patients stayed in the hospital due to pain. Reasons for failure to discharge included urinary retention, drowsiness, vomiting, and anxiety, but not pain. No patients were readmitted to the ED. One patient visited UC for constipation. One patient had bar migration requiring return to the OR for revision. Ten (66.7%) patients did not use opioids after discharge. Conclusions Same day discharge is feasible and safe in PE patients undergoing Nuss procedure with INC and INB. INC with INB can adequately control pain without significant complications. Same day discharge can be safely considered for PE patients undergoing Nuss procedure with INC with INB. Type of study Prognosis study Level-of-evidence rating Level II |
| Databáze: | OpenAIRE |
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