Abstract
Introduction The addition of ultrasound-guided percutaneous cryoanalgesia (PCr) for pain management
after pectus excavatum (PE) surgery offers a new and advantageous approach. Our aim
is to describe our experience with PCr applied on the same day, 24 hours, and 48 hours
prior to PE surgery.
Material and Methods Prospective pilot study in patients undergoing ultrasound-guided PCr (2019–2022)
was divided into three groups: PCr on the same day of surgery (PCrSD), PCr 24 hours
before (PCr24), and PCr 48 hours before (PCr48). We describe the application of technique
and data obtained by comparing the three groups.
Results We present 42 patients (25 PCrSD, 11 PCr24, 6 PCr48). PCr24 had a shorter procedure
duration than PCrSD (65.8 vs. 91.2 minute; p = 0.048). Related to analgesia, PCr24 and PCr48 showed lower opioid consumption than
PCrSD in PCA volume (48.5 and 49.6 vs. 75.1 mL; p = 0.015) and PCA time (23.3 and 23.8 vs. 34.3 hours; p = 0.01). Degree of pain (VAS scale) on the day of surgery and on the second postoperative
day was lower in PCr24 and PCr48 than in PCrSD (4 and 2 vs. 5; p = 0.012; 0 and 1 vs. 2; p = 0.01, respectively) as well as shorter hospital stay (3 and 3.5 vs. 5 days; p = 0.021). In addition, PCr24 showed lower opioid consumption and hospital stay than
PCr48 (p > 0.05). The greatest savings in hospital costs were obtained in the PCr24
group.
Conclusion PCr48 and PCr24 prior to PE surgery offers lower opioid consumption, less pain and
shorter hospital stay than PCrSD. PCr24 is comparable to PCr48, but seems to show
advantages and simpler logistics for the patient and the hospital.
Keywords
pectus excavatum - percutaneous - cryoanalgesia - patient-controlled analgesia
