Pain Management With Cryo Nerve Block In Patients Undergoing Coronary Artery Bypass Grafting
Aleksander Dokollari1, Serge Sicouri2, Leila Hosseinian1, Ozgun Erten2, Basel Ramlawi1, Francis Sutter1, Gianluca Torregrossa1.
1Lankenau Medical Center, Wynnewood, PA, USA, 2Lankenau Institute for Medical Research, Wynnewood, PA, USA.
BACKGROUND: The main goal of this study is to investigate the impact of Cryo Nerve Block, CryoICE™ utilization on post-operative pain in patients undergoing coronary artery bypass grafting (CABG) through left thoracotomy. METHODS: This is retrospective investigational analysis of consecutive patients undergoing isolated CABG through left thoracotomy using CryoICE™ between July 2021 and July 2022 from a single surgeon. The main goal is investigation of post-operative pain in patients undergoing left thoracotomy CABG with CryoICE™, utilizing visual-pain questionnaires. A second cohort of patients without CryoICE™, undergoing the same surgical procedure from the same surgeon, was used as a control group for in-hospital opioids use. RESULTS: A total of 60 patients underwent the surgical procedure using CryoICE™. The mean value of incisional pain at hospital discharge was 1.5 (scale 0-10) and at follow-up was 0.69 (scale 0-10). The mean value of elicited pain with movement at hospital discharge was 1.15 (scale 0-10). Mean values of skin numbness at hospital discharge were 1 (scale 0-10) and 0.57 (scale 0-10) at follow-up. Mean values of skin hypersensitivity at hospital discharge were 1.1 (scale 0-10) and 0.9 (scale 0-10) at follow-up. Mean values of pain affecting the quality of sleep and pain at breathing were both 0.34 (scale 0-10) upon hospital discharge and follow-up. The total in-hospital morphine milligram equivalent was 49% lower in the CryoICE™ versus the non-CryoICE™ cohort. CONCLUSION: Clinical outcomes are solid with a very low incidence of pain, numbness, and hypersensitivity for all comers, undergoing isolated left thoracotomy CABG with cryoICE™ utilization.
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