Pain is significantly reduced by cryoablation therapy in patients with lateral minithoracotomy.
BACKGROUND
In minimally invasive cardiac surgery use of a lateral minithoracotomy is associated with early postoperative rehabilitation but also relatively high pain levels during the first 3 postoperative days. Cryoablation therapy was evaluated prospectively.


METHODS
From April 1999 until September 1999, 57 patients underwent lateral minithoracotomy for mitral valve operation (n = 18) or minimally invasive direct coronary artery bypass grafting (n = 39). Intraoperatively, patients were randomly assigned to cryoablation or intercostal application of local anesthetic agents. A standardized questionnaire was used for prospective pain assessment on postoperative days 1 to 7.


RESULTS
From postoperative day 1 to 7 pain levels declined in all groups. Overall pain levels were significantly lower in the cryo group than in the control group (p < 0.0001, GLM). According to diagnoses, pain levels were significantly lower after MIDCABG and cryo versus control; after mitral valve operation they were lower in the cryo group and almost reached significance.


CONCLUSIONS
Cryoablation is easy to perform and leads to a significant reduction in pain and lower request for additional pain medication after lateral minithoracotomy in minimally invasive cardiac operation.
Bucerius
J
J
Department of Cardiac Surgery, Heartcenter, University of Leipzig, Germany. bucerj@medizin.uni-leipzig.de
Metz
S
S
Walther
T
T
Doll
N
N
Falk
V
V
Diegeler
A
A
Autschbach
R
R
Mohr
F W
FW
D000779:Anesthetics, Local / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000379:methods; D003452:Cryosurgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008943:Mitral Valve / Q000601:surgery; D010149:Postoperative Pain / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*
D000779:Anesthetics, Local