Intercostal nerve cryoablation is associated with lower hospital cost during minimally invasive Nuss procedure for pectus excavatum
| Autor: | Taylor Aiken, Peter F. Nichol, Charles M. Leys, Adam S. Brinkman, Christopher C. Stahl, Benjamin J. Walker, Deborah Lemaster, Daniel E. Abbott, Timothy Casias |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Intercostal nerves Nuss procedure Cryosurgery Article 03 medical and health sciences 0302 clinical medicine Pectus excavatum Pain control 030225 pediatrics Humans Minimally Invasive Surgical Procedures Medicine Hospital Costs Child Retrospective Studies Pain Postoperative business.industry Cryoablation Retrospective cohort study General Medicine Hospital cost medicine.disease Surgery Treatment Outcome Opioid Funnel Chest 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Intercostal Nerves business medicine.drug |
| Zdroj: | J Pediatr Surg |
| ISSN: | 0022-3468 |
| Popis: | Minimally invasive repair of pectus excavatum (Nuss procedure) is associated with significant pain, and efforts to control pain impact resource utilization. Bilateral thoracic intercostal nerve cryoablation has been proposed as a novel technique to improve post-operative pain control, though the impact on hospital cost is unknown.We conducted a retrospective study of patients undergoing a Nuss procedure from 2016 to 2019. Patients who received cryoablation were compared to those that received traditional pain control (patient-controlled analgesia or epidural). Outcome variables included postoperative opioid usage (milligram morphine equivalents, MME), length of stay (LOS), and hospital cost.Thirty-five of 73 patients studied (48%) received intercostal nerve cryoablation. LOS (1.0 vs 4.0 days, p 0.01) and total hospital cost ($21,924 versus $23,694, p = 0.04) were decreased in the cryoablation cohort, despite longer operative time (152 vs 74 min, p 0.01). Cryoablation was associated with decreased opioid usage (15.0 versus 148.6 MME, p 0.01) during the 24 h following surgery and this persisted over the entire postoperative period, including discharge opioid prescription (112.5 vs 300.0 MME, p 0.01).Bilateral intercostal nerve cryoablation is associated with decreased postoperative opioid usage and decreased resource utilization in pediatric patients undergoing a minimally invasive Nuss procedure for pectus excavatum.Retrospective comparative study, level III. |
| Databáze: | OpenAIRE |
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