Journal article
Infectious complications of intercostal nerve cryoablation mediated by perioperative hypothermia during pediatric Nuss procedure
Journal of pediatric surgery, Vol.57(6), pp.1083-1086
06/01/2022
DOI: 10.1016/j.jpedsurg.2022.01.044
PMID: 35232599
Abstract
Background: Intercostal nerve cryoablation (cryoanalgesia) is increasingly used for pain control in mini-mally invasive repair of pectus excavatum (MIRPE) by Nuss procedure. Cryoanalgesia may lower core body temperature and increase the risk of postoperative infectious complications. We investigated cryoanalge-sia effects on infectious complications following MIRPE.
Method: We performed a retrospective review of patients undergoing MIRPE at our institution. Pa-tients treated via multimodal analgesia with cryoanalgesia (Cryo) were compared to patients treated via multimodal analgesia +/-elastomeric pain pumps (Non-cryo). Core body and intraoperative mini-mum/maximum temperatures were recorded. Primary outcomes were wound infection and pneumonia; secondary outcome was length of stay (LOS). Fisher's Exact and Mann-Whitney U tests compared proportions and medians respectively, p-value <= 0.05 being significant.
Results: 80 patients were included, 35(43.7%) Cryo and 45(56.3%) Non-cryo. There were no significant differences in median [IQR] for age(15[13.3,16.0];p = 0.86), number of bars inserted (2[1,2]; p = 0.57), or operative time(123.5[98.3, 148.8]; p = 0.11) between the two groups. We found no significant differences in median [IQR] minimum temperature (35.4 degrees C [35.0,35.8]; p = 0.76), median change in intraoperative temperature (-0.13 degrees C [-0.44,0.00]; p = 0.94) or median recovery temperature (-1.10 degrees C [-1.56,-0.65]; p = 0.59) between Cryo and Non-cryo. PACU temperature was significantly lower in the Cryo group, 36.4 degrees C [36.2,36.6] p = 0.04. There were no postoperative wound infections in either group and no significant difference in incidence of postoperative pneumonia (8.57% versus 2.22%, p = 0.31) or median[IQR] for LOS (4[3,4]; p = 0.57), between Cryo and Non-cryo patients.
Conclusion: Although cryoanalgesia for MIRPE resulted in lower core body temperature, there appears to be no significant difference between Cryo and Non-Cryo patients for LOS or infectious complications. (C) 2022 Published by Elsevier Inc.
Details
- Title: Subtitle
- Infectious complications of intercostal nerve cryoablation mediated by perioperative hypothermia during pediatric Nuss procedure
- Creators
- Nikkida T. Bundrant - Phoenix Children's HospitalLois W. Sayrs - Children's Hospital of Orange CountyDaniel Ostlie - Phoenix Children's HospitalJustin Lee - Phoenix Children's HospitalCraig Egan - Phoenix Children's HospitalMark Molitor - Phoenix Children's HospitalDavid Notrica - Phoenix Children's HospitalBenjamin Padilla - Phoenix Children's Hospital
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric surgery, Vol.57(6), pp.1083-1086
- DOI
- 10.1016/j.jpedsurg.2022.01.044
- PMID
- 35232599
- NLM abbreviation
- J Pediatr Surg
- ISSN
- 0022-3468
- eISSN
- 1531-5037
- Publisher
- Elsevier
- Number of pages
- 4
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984949451702771
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