Comparing Two Pain Relief Methods After the Nuss Surgery for Chest Wall Deformity in Patients 14 Years and Older

What this Trial Is About

This observational ambispective study focuses on pediatric patients undergoing the Nuss procedure for pectus excavatum. It aims to compare the effectiveness of two pain management strategies Earlier Percutaneous Intercostal Cryoneurolysis EPIC alone versus EPIC combined with Phrenic Infiltration as Cryo Adjuvant PhICA. The study investigates whether adding PhICA reduces postoperative pain scores, the need for rescue tramadol, and differences in hospital stay length, time to oral therapy transition, and mobilization timing, along with any side effects. Patients treated with EPIC alone received preoperative cryoneurolysis 2 to 7 days before surgery, followed by a postoperative systemic analgesia protocol. Those in the combined group received the same treatment plus a phrenic nerve infiltration with low concentration local anesthetic immediately after surgery before awakening. The study compares a retrospective control group EPIC with a prospectively recruited case group PhICA. Participants had pain levels assessed using the Numeric Rating Scale NRS at regular postoperative intervals up to 7 days after surgery. Researchers monitored tramadol use, medication intake, hospital stay duration, and time to mobilization. The primary outcome is postoperative pain through hospital discharge, with secondary outcomes including mobilization time and length of hospital stay. Monitoring for any complications related to the techniques is also part of the study.

Phrenic Infiltration as Cryoanalgesia Adjuvant for Early Postoperative Pain Following the Nuss Procedure