Objective:

To evaluate postoperative outcomes after cryoanalgesia during minimally invasive repair of pectus excavatum (MIRPE) in children younger than 12 years, highlighting the significance of off-label use.

Key Findings:

• Ten patients met inclusion criteria with a mean age of 10.1 years and 70% male.
• Median total inpatient opioid consumption was 0.96 OME/kg, indicating low opioid use.
• Median length of stay was 2 days, suggesting efficient recovery.
• Inpatient pain scores decreased from 2 on postoperative day 0 to 0 on postoperative day 1, reflecting effective pain management.
• Two postoperative complications occurred, neither attributable to cryoanalgesia, indicating safety.
• No persistent pain, paresthesia, or numbness reported by 9 months postoperatively, underscoring long-term safety.

Interpretation:

Off-label cryoanalgesia during MIRPE in children aged 9–11 years was feasible with low opioid use and acceptable pain control, suggesting potential for broader application in pediatric surgery.

Limitations:

• Small sample size of only ten patients, limiting statistical power.
• Retrospective design may limit generalizability and introduce selection bias.

Conclusion:

Cryoanalgesia in this age group was associated with low opioid use, short length of stay, and no cryoanalgesia-related complications; larger prospective studies are needed to validate these findings and inform clinical practice.