Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis
Background: Lung transplantation is a crucial treatment for end-stage lung diseases. However, postoperative pain management remains a significant challenge. Therefore, this study aims to examine the implications of adoption cryoanalgesia on lung transplantation pain control protocol. Methods: Three...
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Elsevier
2025-05-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425000588 |
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| author | Felipe S. Passos, MD Pedro B. Bregion, MS Rachid E. Oliveira, MD Thierry Siemeni, MD Ricardo E. Treml, MD, DESAIC Bernardo M. Pessoa, MD Hristo Kirov, MD Torsten Doenst, MD, PhD Shaf Keshavjee, MD, FRCSC Tulio Caldonazo, MD |
| author_facet | Felipe S. Passos, MD Pedro B. Bregion, MS Rachid E. Oliveira, MD Thierry Siemeni, MD Ricardo E. Treml, MD, DESAIC Bernardo M. Pessoa, MD Hristo Kirov, MD Torsten Doenst, MD, PhD Shaf Keshavjee, MD, FRCSC Tulio Caldonazo, MD |
| author_sort | Felipe S. Passos, MD |
| collection | DOAJ |
| description | Background: Lung transplantation is a crucial treatment for end-stage lung diseases. However, postoperative pain management remains a significant challenge. Therefore, this study aims to examine the implications of adoption cryoanalgesia on lung transplantation pain control protocol. Methods: Three databases were searched for studies comparing cryoanalgesia versus standard of care analgesia in patients after lung transplantation. The primary outcome was opioid consumption throughout the entire hospitalization, at postoperative day (POD) 7 and at POD 14 addressed with Morphine Milligram Equivalents (MME). The secondary outcomes were maximum reported pain score at POD 7, hospital length of stay (LOS) and time until extubation. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated for continuous outcomes. Results: A total of 5 studies encompassing 485 patients undergoing lung transplantation were included, of whom 228 underwent cryoanalgesia. Compared to standard of care, cryoanalgesia demonstrated significant reduction in opioid consumption at POD 7 (MD: −96.79 MME, 95% CI −183.40 to −10.18, p=0.03), at POD 14 (MD −225,26 MME; 95% CI −366.58 to −83.94; p<0.01) and throughout the entire hospitalization (MD: −307.76 MME, 95% CI −461.72 to −153.79, p<0.01). In addition, there was a significant reduction in pain scores in the cryoanalgesia group (MD: −1.10 points, 95% CI −1.77 to −0.43, p<0.01). However, no significant differences were found regarding hospital LOS or time until extubation. Conclusions: This meta-analysis indicates that cryoanalgesia effectively reduces opioid requirements and pain levels in lung transplant patients. |
| format | Article |
| id | doaj-art-62d4fafbde6847d3bd4fb3081bc41f50 |
| institution | OA Journals |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | JHLT Open |
| spelling | doaj-art-62d4fafbde6847d3bd4fb3081bc41f502025-08-20T02:16:13ZengElsevierJHLT Open2950-13342025-05-01810026310.1016/j.jhlto.2025.100263Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysisFelipe S. Passos, MD0Pedro B. Bregion, MS1Rachid E. Oliveira, MD2Thierry Siemeni, MD3Ricardo E. Treml, MD, DESAIC4Bernardo M. Pessoa, MD5Hristo Kirov, MD6Torsten Doenst, MD, PhD7Shaf Keshavjee, MD, FRCSC8Tulio Caldonazo, MD9Department of Thoracic Surgery, INCAR Hospital, Santo Antônio de Jesus, BrazilState University of Campinas, São Paulo, BrazilDepartment of Thoracic Surgery, Barretos Cancer Hospital, Barretos, BrazilDepartment of Cardiothoracic Surgery, Jena University Hospital, Jena, GermanyDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford School of Medicine, CaliforniaDepartment of Thoracic Surgery, University of Alberta, Edmonton, CanadaDepartment of Cardiothoracic Surgery, Jena University Hospital, Jena, GermanyDepartment of Cardiothoracic Surgery, Jena University Hospital, Jena, GermanyDivision of Thoracic Surgery, Toronto Lung Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, CanadaDepartment of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany; Department of Cardiothoracic Surgery, Weil Cornell Medicine, New York; Corresponding author: Tulio Caldonazo, MD, Department of Cardiothoracic Surgery, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. Telephone: +49 03641 9 322901Background: Lung transplantation is a crucial treatment for end-stage lung diseases. However, postoperative pain management remains a significant challenge. Therefore, this study aims to examine the implications of adoption cryoanalgesia on lung transplantation pain control protocol. Methods: Three databases were searched for studies comparing cryoanalgesia versus standard of care analgesia in patients after lung transplantation. The primary outcome was opioid consumption throughout the entire hospitalization, at postoperative day (POD) 7 and at POD 14 addressed with Morphine Milligram Equivalents (MME). The secondary outcomes were maximum reported pain score at POD 7, hospital length of stay (LOS) and time until extubation. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated for continuous outcomes. Results: A total of 5 studies encompassing 485 patients undergoing lung transplantation were included, of whom 228 underwent cryoanalgesia. Compared to standard of care, cryoanalgesia demonstrated significant reduction in opioid consumption at POD 7 (MD: −96.79 MME, 95% CI −183.40 to −10.18, p=0.03), at POD 14 (MD −225,26 MME; 95% CI −366.58 to −83.94; p<0.01) and throughout the entire hospitalization (MD: −307.76 MME, 95% CI −461.72 to −153.79, p<0.01). In addition, there was a significant reduction in pain scores in the cryoanalgesia group (MD: −1.10 points, 95% CI −1.77 to −0.43, p<0.01). However, no significant differences were found regarding hospital LOS or time until extubation. Conclusions: This meta-analysis indicates that cryoanalgesia effectively reduces opioid requirements and pain levels in lung transplant patients.http://www.sciencedirect.com/science/article/pii/S2950133425000588CryoanalgesiaEpidural analgesiaStandard of care analgesiaLung transplantation |
| spellingShingle | Felipe S. Passos, MD Pedro B. Bregion, MS Rachid E. Oliveira, MD Thierry Siemeni, MD Ricardo E. Treml, MD, DESAIC Bernardo M. Pessoa, MD Hristo Kirov, MD Torsten Doenst, MD, PhD Shaf Keshavjee, MD, FRCSC Tulio Caldonazo, MD Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis JHLT Open Cryoanalgesia Epidural analgesia Standard of care analgesia Lung transplantation |
| title | Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis |
| title_full | Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis |
| title_fullStr | Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis |
| title_full_unstemmed | Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis |
| title_short | Cryoanalgesia in Lung Transplantation – A Systematic Review and Meta-analysis |
| title_sort | cryoanalgesia in lung transplantation a systematic review and meta analysis |
| topic | Cryoanalgesia Epidural analgesia Standard of care analgesia Lung transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425000588 |
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