Cryoablation for Pain Control in Children Undergoing Pectus Bar Placement

In children with pectus excavatum, a condition in which the sternum caves inward leading to chest pain and difficulty breathing, pectus bar placement can correct the defect. This procedure can cause significant postoperative pain, which is the most significant factor leading to increased length of stay. Many pain management strategies have been developed, including epidural placement. This is not without its own risks, including increased hospital length of stay and the risk of postoperative urinary retention. Most children stayed in the hospital for nearly five days after surgery.

A new strategy in pain control, called cryoablation, emerged within the last several years. We examined our results using this new technique compared to the older methods of pain control. We found that hospital length of stay and postoperative pain medication need was shorter in those who underwent cryoablation when compared to both epidural and IV narcotics. Cryoablation has become our standard practice when placing a pectus bar and can be performed utilizing a minimally invasive technique through the same incisions used for surgery.

Now, pectus bar surgery typically only requires a one-day stay in the hospital. Not only are children able to return home sooner, but their postoperative pain is greatly improved. We are currently examining specific pain scores and postoperative pain medication requirements of children undergoing cryoablation in a prospective study.