Surgical oncology · 2026
Clinical predictors of pain 24 Months after intraoperative intercostal nerve Cryoanalgesia for anatomical lung resection.
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McCaffrey Jonas M, Sniatkewicz David A, Wiesemann Sebastian, Kaifi Jussuf T, Klifto Kevin M
Аннотация
BACKGROUND: Postoperative pain following thoracic surgery remains a clinical challenge, often necessitating prolonged opioid therapy with increased risks of opioid tolerance and dependence. Intraoperative cryoanalgesia has emerged as a potential strategy to reduce postoperative pain, however long-term efficacy and safety remains unknown. We identified predictors of persistent thoracic pain at 24-months following thoracic surgery in patients who underwent intraoperative cryoanalgesia.
METHODS: Retrospective analysis was performed to include patients ages 15 years and older who underwent anatomic lung resection and intraoperative cryoanalgesia from January 2017 to 2022. Patients were excluded if they had a diagnosis of chronic pain or were taking opioids prior to surgery. Patients were stratified by thoracic pain status (no pain at 24 months or pain at 24 months) following surgery. Cohorts were analyzed using univariate analyses, followed by multivariate regression to identify predictors of thoracic pain at 24 months.
RESULTS: A total of 261 patients were included (no pain at 24 months = 167; pain at 24 months = 91). Independent predictors of no pain at 24 months were male sex (OR:0.53, 95%CI:0.29-0.95; p = 0.034) and using a rib spreader (OR:0.46, 95%CI:0.23-0.91; p = 0.027). Independent predictors of pain at 24 months were any postoperative complication (OR:2.5, 95%CI:1.4-4.3; p = 0.001) and opioid use at first clinic follow up (OR:1.8, 95%CI:1.1-3.2; p = 0.031).
CONCLUSIONS: Female sex, opioid use at first clinic follow up, not using a rib spreader, and postoperative complications, may serve as important predictors of thoracic pain at 24 months following intraoperative intercostal nerve targeted cryoanalgesia during thoracic surgery.
METHODS: Retrospective analysis was performed to include patients ages 15 years and older who underwent anatomic lung resection and intraoperative cryoanalgesia from January 2017 to 2022. Patients were excluded if they had a diagnosis of chronic pain or were taking opioids prior to surgery. Patients were stratified by thoracic pain status (no pain at 24 months or pain at 24 months) following surgery. Cohorts were analyzed using univariate analyses, followed by multivariate regression to identify predictors of thoracic pain at 24 months.
RESULTS: A total of 261 patients were included (no pain at 24 months = 167; pain at 24 months = 91). Independent predictors of no pain at 24 months were male sex (OR:0.53, 95%CI:0.29-0.95; p = 0.034) and using a rib spreader (OR:0.46, 95%CI:0.23-0.91; p = 0.027). Independent predictors of pain at 24 months were any postoperative complication (OR:2.5, 95%CI:1.4-4.3; p = 0.001) and opioid use at first clinic follow up (OR:1.8, 95%CI:1.1-3.2; p = 0.031).
CONCLUSIONS: Female sex, opioid use at first clinic follow up, not using a rib spreader, and postoperative complications, may serve as important predictors of thoracic pain at 24 months following intraoperative intercostal nerve targeted cryoanalgesia during thoracic surgery.