Work

Intraoperative Intercostal Nerve Cryoablation in Thoracotomy Patients: A Technique to Expedite Recovery

Year: 2026

Type: article

Abstract: BACKGROUND Severe postoperative thoracotomy pain is common, and studies on intercostal nerve cryoablation (INC) have shown mixed results. This research evaluates the effects of intraoperative INC on recovery metrics at a single institution versus historical controls without INC. We hypothesize that combining INC alongside multimodal analgesia will improve postoperative outcomes. METHODS This retrospective study reviewed 155 thoracotomy patients from 2019-2024, with 125 eligible (IRB #5309). Patients who received INC (n=26) were compared to historical controls (n=99) before its routine use. Outcomes included intensive care unit and hospital length of stay (LOS), reintubation rates, 30-day mortality, and other pain-related outcomes. RESULTS Twenty-six patients (20.8%) with INC were older (mean age 66.3 vs 59.5 years, p=.031) and more likely to take pain-modulating medication preoperatively (61.5% vs 38.4%, p=.034). Their hospital (7.7 vs. 11.7 days, p=.048, 34.2% reduction) and intensive care unit LOS (1.7 vs. 4.8 days, p=.008, 64.6% reduction) were both significantly shorter. No reintubations occurred with INC (0% vs. 11.1%, p<.001). At discharge, 88.5% of INC patients were prescribed neuropathic medications versus 66.7% of controls (p=.030), and 76.9% were prescribed opioids versus 50.5% of controls (p=.015). CONCLUSIONS INC is associated with significantly shorter intensive care unit and hospital LOS and a decreased rate of reintubation. INC inpatient opioid consumption was not significantly decreased, and these patients were more frequently prescribed opioids and neuropathic pain medications at discharge. Further research is needed to determine the effect of INC on postoperative opioid consumption and which patients benefit most from INC.

Source: Annals of Thoracic Surgery Short Reports

DOI: 10.1016/j.atssr.2026.08.002

Authors: Micayla Barnett, Kaylan Gee, Christian Probst, Christina Glenn, Patricia N.E. Roberson, Sean Jordan

Institutions: University of Tennessee Health Science Center, University of Tennessee Medical Center, University of Tennessee at Knoxville

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $975