Intraoperative intercostal nerve cryoablation vs. patient-controlled analgesia after thoracotomy: a single-center retrospective cohort study demonstrating comparable early pain and opioid use.
- 1Department of Anesthesia, King Hussein Cancer Center (KHCC), Queen Rania Street, Amman, 11941, Jordan.
- 2Department of Surgery, King Hussein Cancer Center, Queen Rania Street, Amman, 11941, Jordan.
- 3Department of Anesthesia, King Hussein Cancer Center (KHCC), Queen Rania Street, Amman, 11941, Jordan. [email protected].
Abstract
Background and aims
Thoracotomy is among the most painful surgical procedures and is associated with a high risk of chronic postoperative pain. Optimizing perioperative analgesia is essential for enhancing recovery and reducing opioid-related side effects. This study evaluated whether adding intraoperative intercostal nerve cryoablation to standard postoperative analgesia improves pain control and reduces opioid use following thoracotomy.Materials and methods
This retrospective cohort study included patients who underwent thoracotomy at a tertiary cancer center in 2024. Patients receiving intraoperative intercostal nerve cryoablation in addition to standard postoperative analgesia (n = 32) were compared with patients receiving standard postoperative analgesia alone (n = 33). Primary outcomes were pain scores at multiple postoperative intervals and opioid usage, converted into morphine milligram equivalents (MME).Results
Baseline demographics were comparable between groups. Mean pain scores did not differ significantly at 30 min (2.3 vs. 2.3; p = 0.97), Day 1 (2.9 vs. 2.9; p = 0.40), or Day 2 (2.9 vs. 2.9; p = 0.99). Opioid requirements were also similar on Day 1 (14.8 vs. 13.9 mg MME, p = 0.56) and Day 2 (17.7 vs. 20.6 mg MME, p = 0.22). On Day 3, statistical comparison was not applicable due to PCA discontinuation, though mean opioid use was comparable. Female patients reported higher Day 1 pain scores (3.0 vs. 2.8; p = 0.03), without differences in opioid consumption.Conclusions
The addition of intercostal nerve cryoablation was not associated with improved postoperative pain control or reduced opioid use. These findings support cryoablation as a feasible component of multimodal analgesia after thoracotomy. Larger prospective trials with long-term follow-up are warranted to clarify its role in thoracic enhanced recovery pathways.
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BibTeX
@article{aledwan2026intraoperative,
title = {{Intraoperative intercostal nerve cryoablation vs. patient-controlled analgesia after thoracotomy: a single-center retrospective cohort study demonstrating comparable early pain and opioid use.}},
author = {Ahed Al-Edwan and Riad Abdel Jalil and Moh'd Adnan Yousef and Khalaf Shakhareh and Ahmad Alkharabsheh and Asma Shabsough and Mohamed Khaled and Imad Alnimer and Roqayah Al Qaisi and Munir Shawagfeh and Mohammad B Ghanayem},
journal = {Journal of cardiothoracic surgery},
year = {2026},
month = jul,
doi = {10.1186/s13019-026-04528-5},
url = {https://europepmc.org/article/MED/42907860},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Intraoperative intercostal nerve cryoablation vs. patient-controlled analgesia after thoracotomy: a single-center retrospective cohort study demonstrating comparable early pain and opioid use.
AU - Ahed Al-Edwan
AU - Riad Abdel Jalil
AU - Moh'd Adnan Yousef
AU - Khalaf Shakhareh
AU - Ahmad Alkharabsheh
AU - Asma Shabsough
AU - Mohamed Khaled
AU - Imad Alnimer
AU - Roqayah Al Qaisi
AU - Munir Shawagfeh
AU - Mohammad B Ghanayem
PY - 2026
DA - 2026/07/01
JO - Journal of cardiothoracic surgery
DO - 10.1186/s13019-026-04528-5
UR - https://europepmc.org/article/MED/42907860
AB - Background and aims Thoracotomy is among the most painful surgical procedures and is associated with a high risk of chronic postoperative pain. Optimizing perioperative analgesia is essential for enhancing recovery and reducing opioid-related side effects. This study evaluated whether adding intraoperative intercostal nerve cryoablation to standard postoperative analgesia improves pain control and reduces opioid use following thoracotomy.Materials and methods This retrospective cohort study included patients who underwent thoracotomy at a tertiary cancer center in 2024. Patients receiving intraoperative intercostal nerve cryoablation in addition to standard postoperative analgesia (n = 32) were compared with patients receiving standard postoperative analgesia alone (n = 33). Primary outcomes were pain scores at multiple postoperative intervals and opioid usage, converted into morphine milligram equivalents (MME).Results Baseline demographics were comparable between groups. Mean pain scores did not differ significantly at 30 min (2.3 vs. 2.3; p = 0.97), Day 1 (2.9 vs. 2.9; p = 0.40), or Day 2 (2.9 vs. 2.9; p = 0.99). Opioid requirements were also similar on Day 1 (14.8 vs. 13.9 mg MME, p = 0.56) and Day 2 (17.7 vs. 20.6 mg MME, p = 0.22). On Day 3, statistical comparison was not applicable due to PCA discontinuation, though mean opioid use was comparable. Female patients reported higher Day 1 pain scores (3.0 vs. 2.8; p = 0.03), without differences in opioid consumption.Conclusions The addition of intercostal nerve cryoablation was not associated with improved postoperative pain control or reduced opioid use. These findings support cryoablation as a feasible component of multimodal analgesia after thoracotomy. Larger prospective trials with long-term follow-up are warranted to clarify its role in thoracic enhanced recovery pathways.
SN - 1749-8090
ER -