Objective

The Nuss procedure for correction of pectus excavatum is commonly associated with severe postoperative pain. The use of thoracic epidurals has recently come under scrutiny due to post-operative complications. We have conducted a retrospective survey of all patients who underwent the Nuss procedure at our institution, where all patients were managed exclusively with patient controlled anaesthesia. We aim to illustrate that PCA is an effective method of pain control in this cohort.

Methods

A retrospective survey was carried out on 100 patients (93 males and 7 females), with an average age of 28, after undergoing a Nuss bar insertion. The study was conducted between August and October, 2014. The outcome of the study measured patient satisfaction with postoperative analgesia and medication prescribed for home usage. The pre-operative provision of information with regard to patient expectations of pain was also assessed.

Results

The majority of patients were either satisfied or extremely satisfied with the pain management received in hospital following surgery. A substantial number of patients strongly agreed that they were adequately warned about postoperative pain prior to the operation. None of the cohort specified that they experienced more pain than expected. A small minority of patients reported postoperative long-term or chronic pain, with only one reporting that it lasted for longer than 6 months.

Conclusion

Results obtained from retrospective patient satisfaction surveys indicate high efficacy for PCA as a pain management strategy. The large majority of patients did not seek more medication for pain alleviation and found in-hospital treatment sufficient. Further, all patients agreed that they were adequately informed of pain-risk prior to surgery.