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\begin{document}

\title{Intercostal nerve cryoablation reduces opioid utilization after
thoracotomy in children with cancer}



\author[1]{Kathryn McElhinney L}%
\author[1]{Suhail Zeineddin}%
\author[1]{Samantha Ahle L}%
\author[1]{Seth D. Goldstein}%
\author[1]{Timothy Lautz}%
\affil[1]{Ann and Robert H Lurie Children's Hospital of Chicago}%


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  \date{October 31, 2024}


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\begin{abstract}
\textbf{BACKGROUND:} Intercostal 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. \textbf{METHODS:}
A retrospective review was performed of children who underwent
thoracotomy for a cancer diagnosis at a freestanding children's hospital
from 2018-2023. 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.
\textbf{RESULTS:} Twenty-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 5 intercostal levels (range 2-7). Total oral morphine
equivalents (OME) during inpatient admission were significantly lower in
INC patients (137.6mg versus 514.5mg, p=0.002). Routine care patients
were more likely to be discharged with an opioid prescription (30.4\%
versus 80.0\%, p=0.008). Length of stay was similar between patients
with INC and routine care (4 versus 5 days, p=0.15). There were no
differences in rates of reoperation or 30-day readmission (emergency
department (ED) or inpatient). \textbf{CONCLUSTIONS:} INC 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.%
\end{abstract}%



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