Condition and Procedure:
o Pectus excavatum is the most common congenital chest wall deformity in children and

adolescents.1
o Minimally invasive repair of pectus excavatum (MIRPE) is a widely performed corrective

thoracic surgery.
• Pain Management Challenge:

o Thoracic surgeries like MIRPE are inherently painful, prompting research to improve perioperative pain management.

o Effective perioperative pain control is crucial to enhance recovery and reduce hospital stay.

• Newer Pain Management Technique - Intercostal Nerve Cryoablation (INC):
o Performed by surgeons and temporarily ablates intercostal nerves, offering extended

pain relief and potentially reducing opioid use.
o Studies show cryoablation reduces hospital stays and perioperative opioid requirements

but does not consistently improve pain scores.2,3 • Combination Therapy Potential:

o Combining INC with peripheral nerve blocks (e.g., Erector spinae plane block (ESPB), serratus anterior plane block (SAPB), or paravertebral blocks) may improve pain scores and outcomes

o No current studies examine the combined use of INC with ESPB or SAPB for MIRPE patients.

• Study Purpose:
o Evaluate the impact of cryoablation combined with ESPB or SAPB on postoperative

outcomes in MIRPE patients.