title: Pain and anxiety management in minimally invasive repair of pectus excavatum.
abstract: The Nuss procedure for the correction of Pectus Excavatum (PE) is associated with intense postoperative pain. Our strategy to control early postoperative pain is to combine epidural with intravenous analgesia. Our aim was to analyse our pain control strategy by reviewing all the PE cases treated at our institution. Sixty consecutive patients, aged between 12 and 26 years old, received the PE operation at our institution from January, 2007 to September, 2010. The median age was 16 (12-27) with a male/female ratio of about 7/1. An epidural catheter was employed in all the cases, with 38 patients (63%) requiring additional drugs to control pain, which remained in place for 74 hours (72-96). The pain score was higher in male patients, but lower in those younger than 16 years old. Moreover, patients that consumed benzodiazepines had a significant decrease in cumulative opioid intake (P = 0.0408). Both gender and age had an impact on pain control, while we noticed a synergistic effect between opiates and tranquillizers.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital A. Meyer, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ghionzoli
authors.forename: Elisa
authors.initials: E
authors.lastname: Brandigi
authors.forename: Antonio
authors.initials: A
authors.lastname: Messineo
authors.forename: Andrea
authors.initials: A
authors.lastname: Messeri
keywords: MIRPE; Nuss procedure; anxiety; pain; pectus excavatum