CT-guided cryoablation for post-thoracotomy pain syndrome: a retrospective analysis

Yasin, Junaid; Thimmappa, Nanda Deepa; Kaifi, Jussuf T.; Avella, Diego M.; Davis, Ryan M.; Tewari, Sanjit O; Saboo, Sachin S.; Bhat, Ambarish P.

doi:10.5152/dir.2019.19179

Cited by 31 publications

(29 citation statements)

References 19 publications

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“…4), the ablation margins cannot be well seen on imaging and multiple overlapping ablations may be needed to treat large lesions [19]. Additionally, RFA is more painful, necessitating the use of general anesthesia [45,46].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…PTPS is persistent or recurrent pain for at least 2 months after thoracotomy and affects approximately 50% of post-thoracotomy patients [46]. The pathogenesis remains unclear, but PTPS is most likely from a combination of neuropathic and myofascial pain related to intercostal nerve trauma [46]. Management of PTPS can be challenging and refractory to commonly recommended treatments including non-steroidal anti-inflammatory analgesics, opioids,…”

Section: Intercostal Nerve Block For Post-thoracotomy Pain Syndrome (mentioning

confidence: 99%

“…gabapentin, antidepressants, and local or regional anesthesia [46]. PTPS can have a major impact on patient's productivity and mental health, increasing the risk for depression and OUD [72].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Intercostal nerve cryoablation to temporarily impair nerve conduction, rather than cause permanent nerve damage or injury, has been shown to improve pain in patients with PTPS; the post-ablation relief lasts for approximately 6-9 months in most patients [46]. Cryoablation is used instead of RFA given that cryoablation is better tolerated and less likely to cause neuroma formation [46]. The intercostal nerve is targeted at the inferior margin of the rib (Fig.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…8), and cryoablation is performed for 3 minutes at 60% of the power. The technical details and complications from intercostal nerve cryoablation have been previously described [46].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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The Pain Crisis: Interventional Radiology's Role in Pain Management

Fletcher

Moore

Stensby

et al. 2021

American Journal of Roentgenology

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The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Intercostal Nerve Block For Post-thoracotomy Pain Syndrome (mentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

“…8), and cryoablation is performed for 3 minutes at 60% of the power. The technical details and complications from intercostal nerve cryoablation have been previously described [46].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

See 3 more Smart Citations

The Pain Crisis: Interventional Radiology's Role in Pain Management

Fletcher

Moore

Stensby

et al. 2021

American Journal of Roentgenology

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Diagnostic and therapeutic blocks

Stogicza¹,

Peng

2022

Clinical Pain Management

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Intercostal nerve cryoablation reduces opioid utilization after thoracotomy in children with cancer

McElhinney,

Zeineddin,

Ahle

et al. 2023

Pediatric Blood & Cancer

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BackgroundIntercostal nerve cryoablation (INC) has shown promise as an adjunct method for analgesia in adults undergoing thoracotomy, but has yet to be widely used in children for this indication. We hypothesize that INC decreases opioid utilization in children undergoing thoracotomy for cancer operations.MethodsA retrospective review was performed of children who underwent thoracotomy for cancer diagnosis at a freestanding children's hospital from 2018 to 2023. Patient characteristics, intraoperative data, and data on clinical course were collected. Patients were divided into those who underwent INC and those who underwent routine care for comparison.ResultsTwenty‐six patients underwent 38 procedures at a median age of 16 years (range 5–21 years). INC was performed in 23 cases over a median of five intercostal levels (range 2–7). Total oral morphine equivalents during inpatient admission were significantly lower in INC patients (137.6 vs. 514.5 mg, p = .002). Routine care patients were more likely to be discharged with an opioid prescription (30.4% vs. 80.0%, p = .008). Length of stay was similar between patients with INC and routine care (4 vs. 5 days, p = .15). There were no differences in rates of reoperation or 30‐day re‐admission (emergency department or inpatient).ConclustionsINC is a feasible and safe adjunct for children undergoing thoracotomy for cancer. INC is associated with reduced postoperative opioid utilization with respect to both inpatient use and outpatient prescriptions.

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CT-guided cryoablation for post-thoracotomy pain syndrome: a retrospective analysis

Cited by 31 publications

References 19 publications

The Pain Crisis: Interventional Radiology's Role in Pain Management

The Pain Crisis: Interventional Radiology's Role in Pain Management

Diagnostic and therapeutic blocks

Intercostal nerve cryoablation reduces opioid utilization after thoracotomy in children with cancer

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