The minimally invasive repair of pectus excavatum (MIRPE) is associated with significant postoperative pain and opioid use. The objective of this study was to determine the effect of intercostal nerve cryoablation (Cryo) on inpatient and post-hospital opioid prescription practices following MIPRE. A retrospective review at a single pediatric center was conducted of patients ≤21 years old who underwent MIRPE. Oral morphine equivalents (OME) of inpatient and discharge opioids were compared between Cryo and no-Cryo cohorts. 579 patients were identified (82.8% male, mean age 15.4 ± 2.0 years). Cryo was performed in 73.5% of patients. The total inpatient OME use was less in the Cryo group (0.89 ± 0.68 vs. 1.6 ± 0.5 OME/kg/day; p < 0.001). Patients who underwent Cryo were prescribed significantly less OME at discharge compared to the no-Cryo group (3.9 ± 1.7 vs. 10.0 ± 4.1 OME mg/kg, p < 0.001). There was no statistically significant difference in the proportion of patients who required an opioid prescription refill (Cryo 12.4% vs. no-Cryo 11.5%, p = 0.884) or were readmitted (Cryo 5.3% vs. no-Cryo 4.6%, p = 0.833). Patients who underwent cryoablation during MIRPE were prescribed significantly less opioid at the time of discharge without increasing the need for opioid refills or hospital readmissions. Treatment study; Level III evidence.

中文翻译：

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冷冻消融可减少漏斗胸微创修复术后出院时的阿片类药物处方

漏斗胸微创修复术 (MIRPE) 与明显的术后疼痛和阿片类药物的使用有关。本研究的目的是确定肋间神经冷冻消融 (Cryo) 对 MIPRE 后住院和出院后阿片类药物处方实践的影响。在单个儿科中心对接受 MIRPE 的 ≤21 岁患者进行了回顾性审查。比较了 Cryo 和非 Cryo 队列中住院和出院阿片类药物的口服吗啡当量 (OME)。共确定了 579 名患者（82.8% 为男性，平均年龄 15.4 ± 2.0 岁）。 73.5% 的患者接受了冷冻治疗。 Cryo 组住院患者 OME 的总使用量较少（0.89 ± 0.68 vs. 1.6 ± 0.5 OME/kg/天；p < 0.001）。与非 Cryo 组相比，接受 Cryo 治疗的患者在出院时服用的 OME 显着减少（3.9 ± 1.7 vs. 10.0 ± 4.1 OME mg/kg，p < 0.001）。需要阿片类药物处方补充（Cryo 12.4% vs. no-Cryo 11.5%，p = 0.884）或再次入院（Cryo 5.3% vs. no-Cryo 4.6%，p = 0.884）的患者比例没有统计学上的显着差异。 0.833）。在 MIRPE 期间接受冷冻消融的患者在出院时服用的阿片类药物明显减少，而不会增加阿片类药物补充或再入院的需求。治疗研究； III 级证据。