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The following is a summary of “Intercostal Nerve Cryoablation During Lobectomy for Postsurgical Pain: A Safe and Cost-Effective Intervention,” published in the December 2024 issue of Pain by Miller et al.
The cost-benefit of intercostal nerve cryoablation during surgical lobectomy for postoperative pain management was unknown.
Researchers conducted a retrospective study to compare hospital economics, resource use, and clinical outcomes between patients undergoing lobectomy treated with standard care and cryoablation vs those treated with standard care only, hypothesizing that cryoablation would reduce narcotic use and lower costs.
They used propensity-matched patients with surgery and ministered between 2016 and 2022 from a US National All-Payer Database. Cost and outcome comparisons between groups were performed using chi-square and t-tests.
The results showed that among 266 matched pairs of patients undergoing lobectomy with a mean age of 69 years, 66% (175 pairs) underwent open lobectomy and 53% (142 vs 143 pairs) had the upper lobe resected. Both groups exhibited significant comorbidities and prior opioid use. Cryoablation was associated with a 1.3-day reduction in hospital stay (8.8 vs 10.1 days, P =0.31) and no increase in perioperative complications. At 90 days, patients receiving cryoablation had lower opioid prescription refills (27.3 vs 36.9 morphine milligram equivalents, P =0.03). Patients undergoing cryoablation costs showed a trend towards being lower compared to non-cryoablation during the index hospitalization ($38,753 vs $43,974, P =0.10) and over 6 months (total costs, $65,703 as compared to $74,304, P =0.10). While resource utilization was similar, a smaller proportion of patients undergoing cryoablation required outpatient hospital visits (83.1%, N=221 compared to 92.9%, n=247, P <0.01).
Investigators concluded the cryoablation addition during lobectomy was safest, cost-effective strategy that reduces postoperative pain, leading to shorter hospital stays and decreased opioid use.
Source: link.springer.com/article/10.1007/s40122-024-00694-3
