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Percutaneous Cryoanalgesia: A New Strategy for Pain Management in Pectus Excavatum Surgery.
Velayos, María; Alonso, Mercedes; Delgado-Miguel, Carlos; Estefanía-Fernández, Karla; Muñoz-Serrano, Antonio J; Santamaría, Manuel V López; Reinoso-Barbero, Francisco; De La Torre, Carlos A.
Afiliación
  • Velayos M; Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain.
  • Alonso M; Children's Anesthesia and Resuscitation Department, La Paz University Hospital, Madrid, Spain.
  • Delgado-Miguel C; Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain.
  • Estefanía-Fernández K; Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain.
  • Muñoz-Serrano AJ; Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain.
  • Santamaría MVL; Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain.
  • Reinoso-Barbero F; Children's Anesthesia and Resuscitation Department, La Paz University Hospital, Madrid, Spain.
  • De La Torre CA; Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain.
Eur J Pediatr Surg ; 32(1): 73-79, 2022 Feb.
Article en En | MEDLINE | ID: mdl-34942673
INTRODUCTION: In recent years, pain protocols for pectus excavatum (PE) have incorporated cryoanalgesia through thoracoscopic approach. Since 2019, ultrasound-guided percutaneous cryoanalgesia (PCr) has been applied at our institution, either on the same day as the Nuss procedure or 48 hours before surgery. We carried out a preliminary retrospective review of patients with PE in whom PCr prior to surgery was performed at our institution between 2019 and 2021. MATERIALS AND METHODS: Two groups were evaluated: PCr on the same day (PCrSD) and PCr 48 hours before surgery (PCr48). Despite PCr, patients were treated with "patient-controlled analgesia" (PCA) with opioids for at least 24 hours, switching to conventional intravenous analgesia and oral analgesia in the following days. Demographic, clinical-radiological variables, PCA opioid use, pain grade according to the visual analog scale (VAS), and length of stay (LOS) were compared between the groups. A total of 20 patients were included (12 with PCrSD and 8 with PCr48), without significant differences in demographics or clinical-radiological variables. The overall median time of PCr was 65 minutes (55-127), with no differences between the groups. RESULTS: PCr48 group presented with significantly lower median number of hours of continuous PCA (24 vs. 32 hours; p = 0.031), lower median number of rescue boluses (11 vs. 18; p = 0.042), lower median VAS in the early postoperative hours (2 vs. 5.5; p = 0.043), and lower median LOS (3.5 vs. 5 days). CONCLUSION: PCr performed 48 hours prior to surgery is more effective in terms of PCA requirements, VAS, and LOS when compared with cryoanalgesia on the same day.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tórax en Embudo Tipo de estudio: Guideline / Observational_studies Límite: Humans Idioma: En Revista: Eur J Pediatr Surg Asunto de la revista: PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tórax en Embudo Tipo de estudio: Guideline / Observational_studies Límite: Humans Idioma: En Revista: Eur J Pediatr Surg Asunto de la revista: PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos