Abstract
Purpose: To assess our experience with postoperative pain and analgesia requirements associated with the minimally invasive repair of pectus excavatum in children. Patients and Methods: a retrospective review of the charts of patients operated on between July 1998 and December 1999 was conducted, and all patients and parents were contacted by phone for interviews. Results: Thirty-one patients (8 girls and 23 boys) aged 3 to 18 years (median 9 years) were identified. The average length of stay was 4.7 days. In 29 children, continuous thoracic epidural infusions were initiated, and they were the mainstay of analgesia in 22 children (mean duration of infusion 65 hours). The remaining nine children required a combination of therapies for pain relief. Two patients required oral analgesia for >3 weeks after discharge, one of whom subsequently required surgical revision. Pain assessment using the Wong-Baker nonverbal scoring system showed that on any given day after surgery, children in the 3- to 10-year age group consistently scored lower than those in the 11- to 18-year age group. Conclusions: The length of stay and duration of continuous epidural infusions required after the minimally invasive repair of pectus excavatum in children is similar to that reported for the traditional open repair. Younger children (3-10 years) appeared to tolerate the procedure better than older children (11-18 years).
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