Successful Treatment of Persistent Pain After Pectus Excavatum Repair Using Paravertebral Nerve Radiofrequency Thermoablation.
We present a case of a 25-year-old male patient suffering from severe prolonged pain after uneventful pectus excavatum repair that could be treated successfully by paravertebral nerve radiofrequency thermoablation. The patient was scheduled for a minimally invasive Nuss pectus excavatum repair. Surgical correction was performed under general anesthesia in combination with a thoracic peridural catheter. The immediate postoperative course was uneventful; however, the patient developed severe prolonged bilateral chest wall pain across segments T8 and T9. After failure of conservative treatment options, a specialized interventional anesthesiologist performed paravertebral nerve radiofrequency thermoablation of segment T9 bilaterally, after which the patient was pain free until scheduled removal of the pectus bar 3 years after placement.
From the Departments of *Pediatric and Adolescent Surgery and †Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria; and ‡Department of Anesthesiology and Intensive Care Medicine, General Hospital Klagenfurt, Klagenfurt, Austria.
Hannah Noemi
HN
Ladenhauf
Ottokar
O
Stundner
Rudolf
R
Likar
Jörg
J
Schnöll
Roman P
RP
Metzger
D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D059350:Chronic Pain / Q000517:prevention & control*; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009407:Nerve Block / Q000379:methods; D009984:Orthopedic Fixation Devices / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D013900:Thoracic Nerves; D016896:Treatment Outcome