Eliminating Post-Operative Pain with Intercostal Nerve Cryoablation during Rib Cartilage Harvest for Total Microtia...

Area of Science:

• Plastic Surgery
• Pain Management
• Regenerative Medicine

Background:

• Postoperative pain at the rib cartilage harvest site for microtia construction presents challenges, impacting patient recovery and hospital stay.
• Cryoablation of intercostal nerves has demonstrated efficacy in pain control for pectus excavatum repair, reducing opioid use and hospital duration.
• The mechanism involves reversible axonotmesis of intercostal nerves, with sensory function typically returning within six months.

Purpose of the Study:

• To evaluate the effectiveness of cryoablation of intercostal nerves as a percutaneous pain management strategy for the rib cartilage donor site in microtia reconstruction.
• To assess the impact of this technique on postoperative pain levels, analgesic requirements, and length of hospital stay.

Main Methods:

• A percutaneous approach was utilized to perform cryoablation of intercostal nerves near the rib cartilage harvest site.
• The technique was applied during the surgical procedure for total microtia construction.
• Postoperative pain was monitored, and analgesic use was recorded.

Main Results:

• The novel application of cryoablation provided early and sustained analgesia, evident from postoperative day 1.
• Patients experienced minimal pain at the rib donor site.
• No adverse reactions were reported, and intraoperative time was not significantly increased.

Conclusions:

• Percutaneous cryoablation of intercostal nerves is a promising method for managing pain associated with rib cartilage harvesting in microtia surgery.
• This technique offers a safe and effective alternative for reducing postoperative pain and potentially shortening hospital stays.
• Further investigation may support its broader adoption in reconstructive surgery involving rib cartilage grafts.