• Injury · Sep 2023

    Intercostal nerve cryoablation during surgical stabilization of rib fractures decreases post-operative opioid use, ventilation days, and intensive care days.

    • Matthew N Marturano, Vandan Thakkar, Huaping Wang, Kyle W Cunningham, Cynthia Lauer, Gaurav Sachdev, Samuel W Ross, Mary M Jordan, Sean T Dieffenbaugher, Ronald F Sing, and Bradley W Thomas.
    • Department of Trauma and Acute Care Surgery, Atrium Health-Carolinas Medical Center, Charlotte NC, USA.
    • Injury. 2023 Sep 1; 54 (9): 110803110803.

    BackgroundIntercostal nerve cryoablation is an adjunctive measure that has demonstrated pain control, decrease in opioid consumption, and decrease in hospital length of stay (LOS) in patients who undergo surgical stabilization of rib fractures (SSRF).MethodsSSRF patients from January 2015 to September 2021 were retrospectively compared. All patients received multimodal pain regimens post-operatively and the independent variable was intraoperative cryoablation.Results241 patients met inclusion criteria. 51 (21%) underwent intra-operative cryoablation during SSRF and 191 (79%) did not. Patients with standard treatment consumed 9.4 more daily MME (p = 0.035), consumed 73 percent more post-operative total MME (p = 0.001), spent 1.55 times as many days in the intensive care unit (p = 0.013), and spent 3.8 times as many days on the ventilator than patients treated with cryoablation, respectively. Overall hospital LOS, operative case time, pulmonary complications, MME at discharge, and numeric pain scores at discharge were no different (all p>0.05).ConclusionIntercostal nerve cryoablation during SSRF is associated with fewer ventilator days, ICU LOS, total post-operative, and daily opioid use without increasing time in the operating room or perioperative pulmonary complications.Copyright © 2023 Elsevier Ltd. All rights reserved.

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