Sistema de Salut de Catalunya
Institut Català de la Salut
[Zacha S, Bilas J] Department of Paediatric Orthopaedics and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin, Poland. [Lopez M] Servei de Cirurgia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Skonieczna-Żydecka K] Department of Biochemical Sciences, Pomeranian Medical University, 70-252 Szczecin, Poland. [Miegoń J, Biernawska J] Department of Anaesthesiology and Intensive Therapy, Pomeranian Medical University, 70-252 Szczecin, Poland
Vall d'Hebron Barcelona Hospital Campus
2025-02-18T11:24:57Z
2025-02-18T11:24:57Z
2024-08-18
Nuss surgery; Acute pain; Cryoanalgesia
Cirugía de Nuss; Dolor agudo; Crioanalgesia
Cirurgia de Nuss; Dolor agut; Crioanalgèsia
An inherent defect of the sternum and ribs results in the formation of a funnel-shaped anterior chest wall. The gold standard of surgical correction is the minimally invasive Nuss procedure, which might cause severe pain and carries the risk of sensory disturbances and chronic discomfort. Integrating cryoanalgesia with standard multimodal analgesia improves the outcomes of this procedure. Based on histological results, it was hypothesised that the time of cryo-application can be reduced from the current standard period of two minutes. The goal of this study was to evaluate the efficacy of a one-minute application compared with the routine two-minute method in the same patient, considering the subjective perception of pain and sensory disturbances. A total of 33 patients were included in this prospective study. The results show that the assessment of pain severity and sensory disturbances did not differ significantly in terms of the time of cryo-application during first 14 days after the surgical procedure. The one-minute cryo-application time for intraoperative intercostal nerve cryoablation prior to the Nuss procedure seems to be as safe and effective as the routinely used two-minute application time in regards to pain severity, sensory disturbances, and the risk of chronic pain development. Intercostal nerve cryoanalgesia is an essential element of multimodal analgesia.
Article
Published version
English
Tòrax - Cirurgia; Avaluació de resultats (Assistència sanitària); Tòrax - Malformacions; Analgèsia; Fred - Ús terapèutic; Dolor postoperatori - Prevenció; Infants; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Anesthesia and Analgesia::Analgesia; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Thoracic Surgical Procedures::Thoracotomy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Cryotherapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome; DISEASES::Musculoskeletal Diseases::Musculoskeletal Diseases::Musculoskeletal Abnormalities::Funnel Chest; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Pain, Postoperative; NAMED GROUPS::Persons::Age Groups::Child; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::anestesia y analgesia::analgesia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos torácicos::toracotomía; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::crioterapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento; ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades musculoesqueléticas::anormalidades musculoesqueléticas::tórax en embudo; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::dolor posoperatorio; nino
MDPI
Journal of Personalized Medicine;14(8)
https://doi.org/10.3390/jpm14080875
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
