Ba, Y.F., Li, X.D., Zhang, X., Ning, Z.H., Zhang, H., Liu, Y.N., . . . Li, Y. (2015). Comparison of the analgesic effects of cryoanalgesia vs. parecoxib for lung cancer patients after lobectomy.  Surgery Today, 45, 1250–1254.

DOI Link

Study Purpose

To compare analgesic effects of cryoanalgesia and parecoxib for patients undergoing lobectomy for lung cancer

Intervention Characteristics/Basic Study Process

Patients undergoing open thoracotomy either received cryoanalgesia or parecoxib. Cryoanalgesia was performed on four intercostal nerves. The cryoprobe was placed on each nerve and application was done to induce a temperature of -55 to -65 degrees centigrade. For the other group, 40 mg of parecoxib was given IV push. Postoperative pain and respiratory function was assessed and recorded for seven days.

Sample Characteristics

  • N: 178   
  • AGE: Mean age = 67.5 years (range = 41-78)
  • MALES: 65.7%  
  • FEMALES: 34.3%
  • CURRENT TREATMENT: Other
  • KEY DISEASE CHARACTERISTICS: Most had stage II or III lung cancer

Setting

  • SITE: Single site   
  • SETTING TYPE: Inpatient    
  • LOCATION: China

Phase of Care and Clinical Applications

PHASE OF CARE: Active anti-tumor treatment

Study Design

Observational

Measurement Instruments/Methods

Visual analog scale for pain

Results

During the first week, pain scores of those who received cryoanalgesia were significantly lower than those who received parecoxib (p < 0.05). One month after surgery, those who had cryoanalgesia felt no apparent pain, while the other group had persistent incisional and abdominal pain (p < 0.05). There was no difference between groups 6 months after surgery. Patients in the cryoanalgesia arm used less morphine postoperatively (p < 0.05)

Conclusions

Cryoanalgesia may be an effective approach for short-term postoperative patient management.

Limitations

  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Unintended interventions or applicable interventions not described that would influence results
  • Measurement/methods not well described
  • Other limitations/explanation: The protocol for administration of postoperative pain medications, type of medications, and total dosages are not reported. Method of VAS data collection was not clearly described.

Nursing Implications

Cryoanalgesia appears in this study to have beneficial effects for postoperative pain management for patients undergoing lobectomy for lung cancer. Further research is warranted to evaluate effects of cryoanalgesia in comparison to other known effective approaches.