Abstract
Objective The present study aims to elucidate whether or not scoring deformed cartilages reduces
postoperative pain after the Nuss procedure for pectus excavatum patients.
Methods A total of 46 pectus excavatum patients for whom the Nuss procedure was conducted
were included in the study. The patients were categorized into two groups, depending
on whether or not the supplementary maneuver of scoring deformed cartilages was performed
in addition to the Nuss procedure. Patients for whom deformed costal cartilages were
scored were categorized as the Scoring Group (n = 24); those who received no such scoring were categorized as the Non-Scoring Group
(n = 22). After evaluating the maximum stresses occurring on the thoraces by means of
dynamic simulation using finite element analyses, intergroup comparison of the maximum
von-Mises stress values was performed. Furthermore, after quantifying postoperative
pain as the frequency with which patients injected anesthetics through an epidural
pain-control system within 2 postoperative days, the degree of pain was compared between
the two groups.
Results The maximum stresses occurring on the thorax were significantly greater for the Non-Scoring
Group than for the Scoring Group; injection frequency was also greater for the Non-Scoring
Group (average 4.9 times for 2 days) than for the Scoring Group (average 2.5 times
for 2 days).
Conclusion High stresses occur due to the performance of the Nuss procedure, causing postoperative
pain. The stresses can be reduced by performing supplementary scoring on deformed
cartilages. Accordingly, postoperative pain is reduced.
Keywords
chest - treatment - anesthesia
