{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:17:54Z","timestamp":1780579074625,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The Nuss procedure, also known as minimally invasive repair of pectus excavatum (MIRPE), is recognised to cause high levels of post\u2010operative pain, requiring regional techniques and inpatient and outpatient opioid use. Intercostal nerve cryoablation during MIRPE is a new technique that results in extended analgesia for up to 3\u20136\u2009months after surgery. This multisite comparative analysis is the first to present the use of cryoanalgesia in Australasia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Retrospective chart reviews were conducted of 17 consecutive patients who underwent cryoanalgesia for MIRPE and 17 patients who underwent MIRPE without cryoanalgesia immediately before its introduction to two sites. Oral morphine equivalents were calculated for opiate medications administered and dispensed. The two cohorts were compared using unpaired t\u2010tests for normally distributed data and Mann\u2013Whitney\n U<\/jats:italic>\n tests for non\u2010normally distributed data.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Cryoanalgesia significantly shortened the length of stay\u2014median length of stay 3\u2009days in patients who had cryoanalgesia compared to 5\u2009days in patients with no cryoanalgesia (\n p<\/jats:italic>\n \u2009<\u20090.05). Cryoanalgesia also significantly reduced inpatient opiate use\u2014average oral morphine equivalent 110\u2009mg in patients who received cryoanalgesia compared to 489\u2009mg in those who did not (\n p<\/jats:italic>\n \u2009<\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Use of cryoanalgesia significantly reduced inpatient opioid use and reduced length of stay. Ongoing research is required to establish the safety of this technique and study the long\u2010term effects.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.70714","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:58:47Z","timestamp":1780577927000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cryoanalgesia for Paediatric Minimally Invasive Repair of Pectus Excavatum: An Australian Retrospective Comparative Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4276-360X","authenticated-orcid":false,"given":"Julia F.","family":"Simons","sequence":"first","affiliation":[{"name":"Queensland Children's Hospital South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Bourke","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2455-8063","authenticated-orcid":false,"given":"Fiona J.","family":"Macfarlane","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Choo","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital South Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"issue":"1","key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1053\/j.semtcvs.2009.03.001","article-title":"Anatomical, Histologic, and Genetic Characteristics of Congenital Chest Wall Deformities","volume":"21","author":"Fokin A. 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A.","year":"2022","journal-title":"Journal of Surgical Research"},{"issue":"2","key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jpedsurg.2021.10.034","article-title":"Next Day Discharge After the Nuss Procedure Using Intercostal Nerve Cryoablation, Intercostal Nerve Blocks, and a Perioperative ERAS Pain Protocol","volume":"57","author":"DiFiore J. W.","year":"2022","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jss.2018.05.048","article-title":"Comparing Outcomes With Thoracic Epidural and Intercostal Nerve Cryoablation After Nuss Procedure","volume":"231","author":"Harbaugh C. M.","year":"2018","journal-title":"Journal of Surgical Research"},{"issue":"1","key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jpedsurg.2022.09.032","article-title":"Effectiveness of One Minute Per Level Intercostal Nerve Cryoablation for Postoperative Analgesia After Surgical Correction of Pectus Excavatum","volume":"58","author":"Zeineddin S.","year":"2023","journal-title":"Journal of Pediatric Surgery"},{"issue":"3","key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00383-019-04602-1","article-title":"The Incidence of Neuropathic Pain After Intercostal Cryoablation During the Nuss Procedure","volume":"36","author":"Zobel M. J.","year":"2020","journal-title":"Pediatric Surgery International"},{"key":"e_1_2_6_13_1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.jss.2022.01.009","article-title":"Opioid Requirements After Intercostal Cryoanalgesia in Thoracic Surgery","volume":"274","author":"O'Connor L. A.","year":"2022","journal-title":"Journal of Surgical Research"},{"key":"e_1_2_6_14_1","unstructured":"D.Hill F.Macfarlane C.Bourke andK.Choo \u201cThe Use of Retrolaminar Catheters for Post\u2010Operative Analgesia After the Nuss Procedure\u2014A Case Series \u201dposter presentation in 2015."},{"issue":"1","key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.bpa.2019.02.003","article-title":"Thoracic Wall Blocks: From Paravertebral to Retrolaminar to Serratus to Erector Spinae and Back Again\u2014A Review of Evidence","volume":"33","author":"Chin K. J.","year":"2019","journal-title":"Best Practice & Research. 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