Nuss Procedure Post-Op Care
Once the surgery is completed, your child will be taken to the recovery room or Post-Anesthesia Care Unit (PACU) for observation. As a pediatric hospital, our nurses, anesthesiologists and other healthcare professionals specialize in caring for children who have undergone surgery. They will closely monitor as your child "awakens" from the anesthesia.
The length of time spent in the PACU will depend upon their response to the surgery and anesthesia. Typically, children who have undergone the Nuss procedure are moved to a regular room within a few hours.
To manage any pain your child might experience, the healthcare professionals at CHKD will use a Pain Controlled Analgesia (PCA) pump. The pump allows you or your child to push a button, which releases a small dose of pain medication (based on your child's weight). It is important to NOT to push the button while your child is sleeping.
The machine is programmed to allow a specific dose and the timer on the machine controls how often the medication can be dispensed, even if you or your child pushes the button more frequently.
Pain medications may cause side effects such as nausea, vomiting, itching, constipation or sedation/excessive sleepiness. Your child's doctors will order medications to manage these side effects.
What can a parent do to help?
Because children, especially young ones, can't always verbalize what they're feeling, it may be very challenging to determine the level of pain your child is experiencing. Your child's pain management team - your child's surgeon, anesthesiologist and nurses - generally know the usual discomfort for a given operation and can prescribe medication for it, but you, as a parent, know your child best. The team will work closely with you to manage your child's pain.
If you feel your child's pain is not well-controlled, or if they are too sleepy or troubled with other side effects, talk to your nurse or doctor.
You can expect your child to be in the hospital for four to five days. During that time, we will closely monitor and control their pain, have them do deep-breathing exercises, assist with movement and provide instructions on recovery.
For the first six hours after the operation, your child will need to remain still to minimize the risk of bar displacement. After that time, they can begin to sit up and begin walking with the help of a physical therapist.
Deep-breathing exercises and walking are very important to help your child breathe easier as they recover. Once your child is able to get up and walk around with little assistance and no longer requires an IV for pain management, he or she is ready for discharge.
Leaving the Hospital
Your child should be fine for traveling home by car or plane. For long distances by car, plan on staying overnight at a hotel so your child can rest comfortably. Request the bulkhead seats on airplanes - they have more leg room - and have a wheelchair ready at any layovers.
Once discharged, your child is expected to slowly resume normal, but restricted, activity. Most children are able to return to school in two to three weeks, with exercise restrictions for six weeks (i.e., no physical education, no heavy lifting, etc.). Once your child is fully recovered, he or she may return to regular activity.
We like our pectus patients to be active and athletic before and after surgery. After three months, patients are allowed to return to varsity level sports, but we discourage contact sports such as football, soccer and lacrosse.
For more information on your child's recovery and discharge instructions, please read our Pectus Excavatum Correction Discharge Instructions.
Your child will need to see his pediatrician or primary care physician within two to four weeks of returning home for a surgical post-op visit. We will contact your child's doctor regarding your child's outcome and what to look for during the post-op visit. If you live locally, your child will return to our office for this visit.
We recommend follow-up visits to CHKD at six months, one year and at your child's three- or four-year anniversary for the bar's removal.