Intercostal Nerve Cryoablation Vs Thoracic Epidural Analgesia for Minimally Invasive Repair of Pectus Excavatum

In this single-center randomized trial, 48 patients aged 12–24 undergoing the Nuss procedure for pectus excavatum received intercostal nerve cryoablation (INC) or thoracic epidural analgesia (TEA). INC reduced the length of hospital stay (median, 1 vs 4 days; P < .001) and opioid use by 83 percent during hospitalization and 97 percent after discharge. It also reduced pain on days 7 and 14 and improved early mobilization. Return to work or school was similar between the groups. However, 56 percent of INC patients had persistent chest wall hypoesthesia at six months, highlighting the need for long-term follow-up.