Dokollari Aleksander, Sicouri Serge, Erten Ozgun, Ramlawi Basel, Cameli Matteo, Mandoli Giulia Elena, Bacchi Beatrice, Cabrucci Francesco, Sutter Francis P, Kjelstrom Stephanie, Montone Georgia, Sicouri Noah, Hosseinian Leila, Bonacchi Massimo, Torregrossa Gianluca
Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 3450, USA.
Department of Cardiac Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA 3450, USA.
Rev Cardiovasc Med. 2023 Jun 25;24(6):182. doi: 10.31083/j.rcm2406182. eCollection 2023 Jun.
To investigate the impact of Cryo Nerve Block with cryoICE™ device utilization, on post-operative pain in patients undergoing isolated coronary artery bypass grafting (CABG) through left thoracotomy.
All consecutive patients undergoing isolated CABG through left thoracotomy between July 2021 and July 2022 from a single surgeon were included in the study. Patients using the cryoICE™ device for nerve block were compared for baseline demographics and pre-operative characteristics with those that did not use the cryoICE™ device. A propensity-adjusted analysis was used to compare the two groups. The primary outcome was degree of incisional pain and numbness.
A total of 103 patients underwent isolated CABG through left thoracotomy. After matching, the cryoICE™ device was used for nerve block in 60 patients while the control group included 43 patients. Mean follow-up was 5.7 months. The cryoICE™ device group had a mean value of incisional pain at hospital discharge was 1.5 (scale 0-10) while at follow-up was 0.69 (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. After univariate analysis comparison of cryoICE™ device group (60 patients) versus non-cryoICE™ device group (43 patients), the total in-hospital morphine use was 49% lower in the cryoICE™ versus the non-cryoICE™ cohort (73.8 + 79.37 mg vs 144.1 + 118.99 mg).
Good clinical outcomes were observed in patients undergoing isolated left thoracotomy CABG with cryoICE™ utilization, including a very low incidence of post-operative pain, numbness, and hypersensitivity for all comers.
研究使用cryoICE™设备进行冷冻神经阻滞对经左胸切口行单纯冠状动脉旁路移植术（CABG）患者术后疼痛的影响。
纳入2021年7月至2022年7月间由同一外科医生经左胸切口行单纯CABG的所有连续患者。将使用cryoICE™设备进行神经阻滞的患者与未使用cryoICE™设备的患者进行基线人口统计学和术前特征比较。采用倾向调整分析比较两组。主要结局是切口疼痛程度和麻木情况。
共有103例患者经左胸切口行单纯CABG。匹配后，60例患者使用cryoICE™设备进行神经阻滞，对照组包括43例患者。平均随访5.7个月。cryoICE™设备组出院时切口疼痛平均值为1.5（0 - 10分制），随访时为0.69（0 - 10分制）。出院时皮肤麻木平均值为1（0 - 10分制），随访时为0.57（0 - 10分制）。单因素分析比较cryoICE™设备组（60例患者）与非cryoICE™设备组（43例患者），cryoICE™组住院期间吗啡总用量比非cryoICE™组低49%（73.8 + 79.37 mg对144.1 + 118.99 mg）。
在经左胸切口行单纯CABG并使用cryoICE™设备的患者中观察到良好的临床结局，包括所有患者术后疼痛、麻木和过敏反应的发生率极低。
