Intercostal nerve cryoanalgesia in the treatment of pain in patients operated on by the modified Nuss method with the BackOnFeet application—a new strategy to improve outcomes

Zacha, Sławomir; Andrzejewska, Agata; Jastrzębska-Ligocka, Barbara; Szwed, Aleksander; Modrzejewska, Elżbieta; Zacha, Wojciech; Skonieczna-Żydecka, Karolina; Miegoń, Jakub; Jarosz, Konrad; Biernawska, Jowita

doi:10.3389/fped.2022.1069805

Cited by 6 publications

(20 citation statements)

References 29 publications

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“…This translates into the possibility of a faster return to motor independence during rehabilitation, patient satisfaction, shorter hospitalisation time, and a reduction in overall treatment costs. We were the first in Poland to implement this procedure in children and confirm all the beneficial effects described to date [ 16 , 31 ].…”

Section: Discussionmentioning

confidence: 74%

“…An example is the implementation of cryoanalgesia of intercostal nerves during thoracic deformity correction in relation to standard regional analgesia. The proven benefits of intercostal nerve cryoanalgesia include a reduction in the severity of postoperative pain, the risk of persistent pain, and a reduction in the need for postoperative analgesics [ 16 , 31 ]. This translates into the possibility of a faster return to motor independence during rehabilitation, patient satisfaction, shorter hospitalisation time, and a reduction in overall treatment costs.…”

Section: Discussionmentioning

confidence: 99%

“…Multimodal analgesia with ultrasound-guided regional anaesthesia was used whenever possible. Intraoperative intercostal nerve cryoanalgesia was performed for the first time in children in Poland, in May 2022, and it was added to specific types of surgery to reduce postoperative pain and prevent chronic pain [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

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Novel Interdisciplinary Enhanced Recovery after Surgery Protocol Implementation in Paediatric Orthopaedics

Zacha,

Szwed,

Miegoń

et al. 2023

JPM

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The enhanced recovery after surgery (ERAS) protocol is not routine management in paediatric orthopaedics. Cultural differences or assumptions about the financing of medical care in different countries encourage creative adaptation of general assumptions in local communities. The aim of this study was to compare the quality of the perioperative period before and after the introduction of an interdisciplinary protocol adopted to organisational conditions. A group of 4098 children were included in the “before–after” observational study. The data of 1553 patients (BEFORE group) were analysed in terms of compliance with the enhanced recovery after surgery protocol guidelines and the time and cost of hospitalisation over a 20-month period. A novel interdisciplinary protocol was developed, including an education and training app called BackOnFeet (BOF®), standardised hospital management, and the introduction of methods novel to Poland (intraoperative nerve cryoanalgesia in children). A further 2545 patients (AFTER group) were reassessed over a period of 20 months. It was found that the groups differed in hospitalisation time (p < 0.001), type of procedures, and percentage ratio of costs incurred to revenue generated. The usefulness of the BOF® app as an effective educational tool was demonstrated. The optimisation of perioperative management in paediatric orthopaedics based on novel tools and the interdisciplinary ERAS protocol is possible and brings tangible benefits in psychological, organisational, and financial terms.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Novel Interdisciplinary Enhanced Recovery after Surgery Protocol Implementation in Paediatric Orthopaedics

Zacha,

Szwed,

Miegoń

et al. 2023

JPM

Self Cite

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“…Surgeries often come with pain, which can cause a lot of distress for children. Insufficient pain relief may result in reduced long-term pain tolerance and more pain response 34 . Dexmedetomidine, a highly selective α-2 adrenergic receptor agonist, is becoming increasingly popular in paediatric surgeries due to its ability to produce dose-dependent sedation, anxiolysis, and analgesia without causing respiratory depression 35 .…”

Section: Clinical Application Of Qlbmentioning

confidence: 99%

Ultrasound-guided quadratus lumborum block: a powerful way for reducing postoperative pain

Long,

Yin,

Guo

et al. 2023

Annals of Medicine &Amp; Surgery

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“…To date, the procedure of freezing nerves during surgery has been used in the USA and several European countries. In Poland, intraoperative cryoanalgesia of the intercostal nerves during Nuss surgery in children was performed for the first time in May 2022 at the Department of Paediatric Orthopaedics and Musculoskeletal Oncology of the Pomeranian Medical University in Szczecin [22].…”

Section: Introductionmentioning

confidence: 99%

Benefits of the Erector Spinae Plane Block before Cryoanalgesia in Children Undergoing Surgery for Funnel Chest Deformity

Zacha,

Jarosz,

Kokot

et al. 2023

JPM

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Thoracic surgery causes significant pain despite standard multimodal analgesia. Intraoperative cryoanalgesia may be a solution. The onset of the clinical effect of cryoanalgesia can take 12–36 h. The addition of a regional anaesthesia before the cryoanalgesia procedure can enable analgesic protection for the patient during this period. The main aim of the study was to evaluate the benefits of the erector spinae plane (ESP) block prior to Nuss surgery. The ‘control’ group consisted of 10 teenagers who underwent cryoablation together with intravenous multimodal analgesia according to the standard protocol. The ‘intervention’ group included 26 teenage patients who additionally received an erector spinae plane block before operation. Pain relief (p = 0.015), opioid use (p = 0.009), independent physical activity and rehabilitation (p = 0.020) were faster in the intervention group. No features of local anaesthetic drug toxicity or complications of the ESP block were observed. The bilateral ESP block together with intraoperative intercostal nerve cryoablation performed prior to Nuss correction of funnel chest were more effective in terms of pain control.

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Intercostal nerve cryoanalgesia in the treatment of pain in patients operated on by the modified Nuss method with the BackOnFeet application—a new strategy to improve outcomes

Abstract: GRAPHICAL ABSTRACTStandarized care with ERAS protocol for NUSS surgery and its benefits.

Cited by 6 publications

References 29 publications

Novel Interdisciplinary Enhanced Recovery after Surgery Protocol Implementation in Paediatric Orthopaedics

Novel Interdisciplinary Enhanced Recovery after Surgery Protocol Implementation in Paediatric Orthopaedics

Ultrasound-guided quadratus lumborum block: a powerful way for reducing postoperative pain

Benefits of the Erector Spinae Plane Block before Cryoanalgesia in Children Undergoing Surgery for Funnel Chest Deformity

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