Introduction:
The Nuss procedure is the gold standard for correcting pectus excavatum. Despite its effectiveness, the postoperative period is often associated with significant pain, which may persist for weeks and typically requires intravenous analgesia, often opioid-based. Cryoanalgesia, a reversible method that induces temporary intercostal nerve block, offers a safe alternative providing both early and long-lasting pain relief.

Aim:
This study evaluates the impact of intraoperative intercostal nerve cryoanalgesia on postoperative pain intensity and hospitalisation duration in patients undergoing the Nuss procedure for pectus excavatum.

Material and methods:
A retrospective analysis was performed on 57 patients treated over a 7-year period at a single centre. Patients were divided into two groups: those who received intraoperative cryoanalgesia (n = 41) and those without additional intraoperative analgesia (n = 16). Statistical analysis was performed using the Mann–Whitney test and Spearman rank correlation, with significance set at p < 0.05.

Results and discussion:
Among the 57 patients, 53 (93%) were male, with a mean Haller Index of 3.98 and Correction Index of 33.78. Cryoanalgesia was applied in 71.9% of cases. Patients treated with cryoanalgesia demonstrated shorter hospital stays compared with the control group (3 ± 2 days vs. 5.5 ± 2 days; p < 0.001). Postoperative pain intensity measured by NRS was comparable between groups; however, opioid requirements were significantly lower in the cryogroup on day 3 (34% vs. 69%; p = 0.02) and day 4 (7% vs. 62.5%; p < 0.001).

Conclusions:
Intraoperative cryoanalgesia reduces hospitalisation time and postoperative opioid use, offering an effective adjunct for pain management after the Nuss procedure.