Spanish national survey on the use of cryoanalgesia in the treatment of funnel chest in pediatric patients.

Abstract

Introduction: Pain control following Nuss thoracoplasty remains a challenge. Cryoanalgesia of the intercostal nerves has been demonstrated to reduce postoperative pain in these patients. The objective of this study was to understand how and how widely cryoanalgesia is used in pediatric patients undergoing funnel chest surgery in Spain.

Materials and methods: Nationwide online submission of an author-designed survey.

Results: 18 hospitals replied to the survey. 9 (50%) said they do not use cryoanalgesia, primarily as a result of difficulties in accessing this technique, whereas the other 9 said they do employ it. In most institutions, cryoanalgesia is percutaneous and ultrasound-guided, and it is conducted 1-3 days before surgery (77.8%). The associated use of other analgesic modalities varies widely, including various combinations of intravenous opioid-based PCA (77.8%), epidural catheter (66.7%), oral pregabalin (66.7%), and erector spinae plane block (22.2%). In the institutions where cryoanalgesia is used, mean hospital stay is 4.7 days. Most surgeons believe cryoanalgesia significantly reduces pain in the long-term (88.9%), and only partially in the immediate postoperative period (66.7%).

Conclusions: The use of cryoanalgesia for pain control following Nuss thoracoplasty is an emergent technique. In the Spanish institutions where this technique is used, varying protocols with different associated analgesic modalities can be found.