Journal article
Intercostal Cryoablation During Video-Assisted Lung Resection Can Decrease Postoperative Opioid Use
Innovations (Philadelphia, Pa.), v 18(4), pp 352-356
01 Jul 2023
PMID: 37461202
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: Pain requiring opioid use remains an issue even with minimally invasive thoracic surgery. The objective of this study was to investigate the effectiveness of intercostal nerve cryoablation (CRYO) for pain control in adult patients undergoing pulmonary resection. Methods: A retrospective analysis of patients undergoing pulmonary resection by uniportal video-assisted thoracic (uVATS) approach was undertaken. Patients treated with our usual pain regimen (STANDARD) were compared with those who additionally received CRYO. STANDARD includes intercostal bupivacaine, patient-controlled analgesia (24 h), ketorolac (48 to 72 h), and tramadol. Intraoperative CRYO was performed on 5 intercostal levels. The primary aim was to compare pain scores (range, 0 to 10) and morphine equivalent dosages (MED). Secondary outcomes included length of stay, chest tube duration, presence of an air leak, and adverse events. A p value <0.05 was considered significant. Results: There were 49 patients (34 female, 15 male). The median age was 74 (37 to 90) years. Procedures included lobectomy ( n = 32), segmentectomy ( n = 7), and wedge resections ( n = 10). There were 23 (46.9%) CRYO and 26 (53.1%) STANDARD patients. Baseline characteristics were similar. Mean length of stay (2.9 vs 3.5 days), chest tube duration (2.2 vs 1.8 days), and adverse events (9 of 23 vs 7 of 26) were similar. There were no complications attributable to CRYO. Pain scores were not significantly different on postoperative days (POD) 1 to 4. MED was significantly reduced after CRYO on POD 1 (5 vs 47.24), POD 2 (10.93 vs 25.04), POD 3 (8.13 vs 21.7), and POD 4 (7.08 vs 19.17). Conclusions: CRYO can be performed safely during pulmonary resection and can decrease in-hospital opioid use. The results from this retrospective study will need to be validated in future prospective studies.
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Details
- Title
- Intercostal Cryoablation During Video-Assisted Lung Resection Can Decrease Postoperative Opioid Use
- Creators
- Conor M. Maxwell - Allegheny General HospitalBenny Weksler - Allegheny Health NetworkJoseph Houda - Allegheny Health NetworkHiran C. Fernando - Allegheny Health Network
- Publication Details
- Innovations (Philadelphia, Pa.), v 18(4), pp 352-356
- Publisher
- Sage
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); Surgery
- Web of Science ID
- WOS:001043003400001
- Scopus ID
- 2-s2.0-85165392467
- Other Identifier
- 991021960645004721
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- Web of Science research areas
- Surgery