Pain is significantly reduced by cryoablation therapy in patients with lateral minithoracotomy

Background. In minimally invasive cardiac surgery use of a lateral minithor acotomy is associated with early postoperative rehabilitation but also rela tively high pain levels during the first 3 postoperative days. Cryoablation therapy was evaluated prospectively. Methods. From April 1999 until September 1999, 57 patients underwent latera l minithoracotomy for mitral valve operation (n = 18) or minimally invasive direct coronary artery bypass grafting (n = 39). Intraoperatively, patient s were randomly assigned to cryoablation or intercostal application of loca l anesthetic agents. A standardized questionnaire was used for prospective pain assessment on postoperative days 1 to 7. Results. From postoperative day I to 7 pain levels declined in all groups. Overall pain levels were significantly lower in the cryo group than in the control group (p < 0.0001, GLM). According to diagnoses, pain levels were s ignificantly lower after MIDCABG and cryo versus control; after mitral valv e operation they were lower in the cryo group and almost reached significan ce. Conclusions. Cryoablation is easy to perform and leads to a significant red uction in pain and lower request for additional pain medication after later al minithoracotomy in minimally invasive cardiac operation. (Ann Thorac Sur g 2000;70:1100-4) (C) 2000 by The Society of Thoracic Surgeons.